[
    {
        "Introduction to Medical Terminology": "hello class and welcome to chapter 5 medical terminology lecture",
        "National EMS Education Standard Competencies": "after you complete this chapter and the related coursework you will be able to use foundational and anatomical medical terms and abbreviation in written and oral communication with colleagues and health care professionals you will understand the purpose of medical terminology be able to identify its components and be able to define an unknown medical term based on the dissection and understanding of its components you will be able to identify error-prone medical abbreviations and acronyms and also common direction movement and positional terms are also presented in this chapter okay so let's start as an introduction",
        "Importance of Medical Terminology for EMTs": "so as an emt you must have a strong working knowledge of medical terminology and this is because for effective communication and documentation you must be able to understand key terms symbols and abbreviations you can determine the meaning of an unknown word by understanding how terms are formed and learning the definitions for parts of a medical term also understanding medical jargon will help you communicate effectively with other members of the ems healthcare and public safety teams all right so let's talk about the anatomy of medical terminology okay so medical terms are made of distinct parts that perform specific functions changing or deleting any of these parts can significantly change the function or the meaning of the word",
        "Anatomy of a Medical Term": "components that comprise medical terms include four parts the four parts are first is the word root the word root is the foundation of that word then you have a prefix a prefix is what occurs before the word root then the suffix that is what occurs after the word root and then you have combining valves now these are vowels that join one or more word roots to other components of a term how the parts of a term are combined determines its meaning accurate spelling is essential in medical terminology the suffix phasea means speaking whereas phagia means eating air swallowing the prefix dis d-y-s means difficult or painful so when you add this with dysphagia it means difficulty speaking while dysphagia means difficulty eating or swallowing so once again accurate spelling is essential knowing anatomy and the context of how these words are used can also help you correctly determine and spell the term in a given situation let's talk about word roots a word root is the main part or stem of a word and this is called the word root you could also you also hear it called root word this conveys the essential meaning of the word and it frequently indicates a body part most terms have at least one word root and some have more than one root adding a prefix or suffix to the word root creates a term changing the prefix or sub suffix will change the meaning of the term and some word roots may also be used as prefixes or suffixes for other terms okay so let's talk about prefixes next",
        "Prefixes, Suffixes, and Combining Vowels": "a prefix is the part of that term and it appears at the beginning of the word so prefixes usually describe location or intensity a prefix gives the word root its specific meaning by learning the commonly used medical prefixes you can figure out the meaning of terms that may not be familiar to you okay then next we have suffixes so suffixes as i re as i said earlier are placed at the end of the words suffixes are usually indicate a procedure condition disease or part of speech then next we have the combining vowels a combining valve is the part of a term that connects a word root to a suffix or another word root in most cases it is an o however it may be an i or an e used when joining a suffix that begins with a constant or when joining another root word the combining valve helps ease the pronunciation of that term a combining uh form is com and it is a combining vowel shown with the root word",
        "Word Building Rules": "so word building rules so there are some rules and the following summarizes the rules covered so far so the prefix is always at the beginning of the term and the suffix is always at the end of the term use the combining valve when a suffix begins with a constant constant and this makes the pronunciation easier and a term has more than one word root a combining vowel must be placed between the two even if the second root begins with a vowel okay now we have plural endings",
        "Plural Endings": "so let's talk about this to change a term from singular to plural certain rules apply so sometimes you can simply just add an s so lung for example becomes lungs but some rules are more complicated so rules you may encounter when converting from singular to plural terms are so here we go a singular word that ends in an a will change to an a e when plural singular words that end in an i s change to e s when plural singular words that end in an e x or an i x will change to i c s singular words that end in an i n book or i m or u m change to an a and singular words that end in a us will change to an i",
        "Special Word Parts: Numbers and Colors": "okay so special word parts prefixes can be used to indicate numbers or colors positions or directions numbers so several prefixes are used to indicate if a term involves a number such as a half one or two parts or sides so example you have uni dipli null primi multi or buy these are examples and then you have colors so several word roots are used to describe colors and some examples of these are cyano leuco uro cyro or melano",
        "Special Word Parts: Positions and Directions": "positions or directions okay so you have a prefix can also be used to describe a position direction or location so examples of these are the ab the add the d the circum the preemie trans epi or supra those are all examples of those positions or directions okay so next we're going to talk about",
        "Common Direction, Movement, and Position Terms": "specific directional terms and why we use these these are needed to discuss specifically where an injury is located you could use them to how pain radiates in the body and so common direction movement and positional terms is what we're going to discuss next and directional terms so directional terms is where we're going to start off with and of course we uh start uh we'll start just talking about right to left so what we want to make sure that you understand though is we're when we talk about the right to left we're talking about patience right patience left okay directional terms and then you have superior and inferior okay so superior towards the head inferior but towards the feet then you have lateral or medial okay towards the um away from the middle aspect of the body medial is more towards the middle you have proximal and then you have distal proximal is more towards the trunk of the body distal is away from the trunk of the body then you have superficial which is on the top and then deep which is deep you have ventral which is more towards the front and then dorsal of course is i think of dorsal fin and that is towards the back you have palmer the palm of the hand planter the sole of the foot and then you have apex towards the bottom right the terms right and left of course just like i said earlier are the patients right and left sides not your right and left side okay and we i mentioned so superior and inferior the superior part of any body part is the portion nearer to the head from a specific reference point so the part nearer to the feet is the inferior portion as i mentioned these terms are also used to describe the relationships of one structure to another so for example the knee is superior to the foot and inferior to the pelvis okay next we have the lateral and medial so these are parts of the body that lie further from the midline like i said and they're called the further from the midline is called lateral so the outer structures and then you have medial and these are the parts that lie closer to the midline okay you have next uh proximal and distal and these are used to describe the relationship of any two structures on an extremity so proximal and distal you're gonna hear it be uh as the extremities so when you hear that term so proximal destruct describe structures that are closer to the trunk then you have of course distal its distance away that's how i think of it and it describes structures that are farther from the trunk or nearer to the free end of the extremity okay you have uh superficial and deep and superficial means closer to or on the skin deep means it's farther inside the body or tissue and away from the skin so a superficial cut versus a deep cut okay and then ventral and dorsal like i said ventral refers to the belly side of the body or the anterior surface of the body dorsal refers to the spinal side or posterior surface of the body and just as i said earlier i think of the dorsal fin of a dolphin which is on the back okay so they uh the more commonly used terms are anterior which is that front um surface of the body and posterior that's the back when you hear instead of ventral or dorsal usually you'll hear anterior or posterior all right and then palmar that's the front region of the hand and it's referred to as the palm also known as the palmer surface and then you have the bottom of the foot it's referred to as the plantar surface and then the apex of course that's the tip of any structure so i they give you an example on the slide it says the apex of the heart is the bottom or inferior portion of the ventricles of the the bottom part of the heart okay all right so next we're going to talk about movement terms so when you talk about movement terms you're talking about first we're going to talk about flexation or extension and this is referring to when we're bending a joint so when we flex a joint flexation of that joint is um bending of the joint extension is straightening of that joint okay next is adduction and abduction i think about add you're moving towards the midline you're adding that movement adduction ab is you're moving away from the midline you're abducting next some other directional terms so a body part that appears on both sides of the midline is bilateral a good way that you'll hear you'll hear this referenced as bilateral breath sounds so both sides both sides breath sounds and then your structures inside the body also appear on both sides of the midline right so sometimes that appears on only one side of the body and we usually call this unilateral and so you'll hear just that example with lung sounds again unilateral breath sounds so you're only hearing one side one lung has breath sounds right okay so use terms properly so that other medical personnel who care for a patient will know immediately where to look and what to expect okay so there are many terms used to describe the position of the patient on your arrival or during transport to the emergency department and so the body is said to be prone if they're laying face down so the prone position is a patient uh laying on the floor let's say or a bed with the face down and then the body is said to be supine supine when the position is found laying up so so face lying up is supine we'd rather have the patient's supine position than prone position right okay so the fowler position is a semi-reclining position with the head elevated to help the patient breathe easier or to control the airway so patient who is sitting upright is said to be in the fowler's position also semi-reclining with the head elevated then you have semi-fowler position and that's when the patient sits with the back of the stretcher at a 45 degree angle so not all the way at the 90 degree angle but a semi fellow position then you have a high fowler position this is when we say that the patient's sitting at a 90 degree angle okay so the first example of",
        "Breaking Terms Apart": "breaking those terms apart we're going to use is that nephropathy and so you have three distinct parts of this you have the pathy and of course that means disease so the pathy means disease the o is the combining form then you have the nephra that is the kidney so nephropathy means disease of the kidney if you when you break it apart okay all right so now let's try another one dysuria so i a we know the ia is a suffix and that is a condition of the dys that is the prefix remember we're working backwards before we're doing the uh suffix then we're going to do the prefix dys dis is the prefix and that means difficulty or painful or abnormal the you are your that's the word root and that means urine so dysuria is painful urination when you put it all together all right next we have hyperemesis you have hyper and emesis so we um we don't have a suffix but we do have a prefix and so we're going to go to the prefix first the prefix is hyper and you're going to see this used a bunch so hyper means excessive then emesis emesis is a word root and it means vomiting so hyperemesis is excessive vomiting you're going to see hyper and emesis a lot in the medical field all right analgesic here's another example so you break it apart you have a suffix and a prefix and a word root in this uh in this term so you have the ic and that is the suffix that means pertaining to okay the a n that is a prefix and that's without or absent of and the the middle term the word root is referring to pain so an analgesic when you put it together it means right what it uh said is um basically without pain pertaining to so pertaining to no pain so an analgesic is how it uh um sounds and and exactly what when you break it down what it means okay okay so",
        "Abbreviations, Acronyms, and Symbols": "now when you come into medical um the medical field you're going to have abbreviations acronyms and symbols and medical abbreviations acronyms and symbols are a type of shorthand that we use for communication this is developed because one could communicate faster using this method but we can only use commonly understood abbreviations to minimize misinterpretations and errors and so the joint commission and the institute of safe medicine practices are considered two authorities on abbreviations and provide do not use lists",
        "Proper Use of Abbreviations and Symbols": "okay so abbreviation so remember to only use standard accepted abbreviations to avoid communication or confusion and errors and when you use an acronym you are shortening several words usually using the first letter of each word to make a shorter term that is pronounced as its own so be familiar with accepted use of abbreviations in your local jurisdiction or service area",
        "Symbols in Medical Communication": "okay and then symbols as with abbreviations it is important to only use the symbols that are widely understood and accepted and there's master tables and the table is in the chapter provided through a reference list of common word roots combining forms prefixes suffixes and abbreviations",
        "Review": "okay and so let's just review so which of the following components of a medical term conveys its essential meaning do you guys remember okay that is c it's the word root and that conveys the essential meaning of the medical term okay prefixes do you remember what they indicate okay prefixes are used to indicate colors numbers positions and directions the plural form of a word bronchus is so the plural form of bronchus is d when the word ends in u.s the plural form will end in an eye so it was bronchi okay this statement the lungs are superior to the bladder indicates that the lungs are closer to the and the correct answer was the head so superior closer to the head versus inferior which is closer to the feet okay movement of an arm towards the midline is referred to remember i said that the arm is going to be if you're moving towards the midline you're adding it towards the midline and so which one is add so it's okay the term adduction is used to describe the movement of the structure towards the midline remember flexation extension is just bending at the joint okay so the correct answer was adduction a body part that lies closer to the midline when compared to another one is and that should be fairly easy it's middle so medial medial is the answer okay this is used to identify a body part that is on the belly side or anterior aspect or surface of the body okay which one was this and you should see it you should recognize it as ventral okay so the ventral which is also uh you'll heard um as the anterior aspect surface of the body the place a you place a position patient in the semi-fowler position for transport and this means the patient is this patient is sitting at a 45 degree angle is said to be semi-fowler a laceration located on the plantar surface is on the and you should recognize that as being the planter surface is the sole of the feet while the palm is the palmer okay all right and last one when using abbreviations acronyms or symbols an emt should hopefully when you look at this you are saying all of the above because an emt should be familiar with those used in your agency should be used only those we're only using those that are medically accepted and we're also using them to shorten documentation okay thank you for joining me for the medical terminology chapter 5 lecture have a great time"
    },
    {
        "Introduction to Nervous System": "hello and welcome back to anatomy and physiology part two of the emergency care in the streets lecture now last uh recording we left off with the muscular skeletal system and now we're gonna pick up with the nervous system okay so let's get started",
        "The Nervous System": "okay the nervous system perhaps the most complex organ in the body the components are the brain spinal cord and thousands of nerves and those nerves allow every part of the body to communicate it's responsible for the found fundamental functions such as breathing pulse rate and blood pressure and it allows for higher level functions such as reading a book enjoying music or having a discussion so the main functions are to monitor the internal and external environments integration of the sensory information and coordination of voluntary and involuntary responses it's divided into the central nervous system which is the cns or the peripheral nervous system which is the pns so the cns is responsible for thought perception feeling and the autonomic body functions and the pns is the somatic nervous system and the autonomic nervous system now the somatic nervous system is the part of the peripheral nervous system that regulates activities over which there is voluntary control so you could pick stuff up and put stuff down that's the somatic now the autonomic nervous system it controls the body functions that occur without voluntary control so involuntary the figure shows the organization of the nervous system neuro tissue is the responsible for the conduction of electrical impulses between the brain and the rest of the body it contains two basic types of cells you have the neuroglia and the neurons the neuroglia provides a supporting skeleton for neural tissue it isolates and protects the cell membrane of the neurons there's types of neuroglia cells and they include astrocytes and those are found in the central nervous system the most numerous type of neuroglia then you have microglia cells all of geosites and satellite sites swan cells so multiple different types neurons are nerve cells they are the fundamental element of the nervous system present throughout the body they are groups of nerve cells are bundled together to form nerve fibers and groups of nerve fibers are bundled together to form a nerve which is the tissue that connects the nervous system with body parts of organs neurons are supplied with oxygen and nutrients from the nerve's blood vessels and nerves are information highways impulses that travel to and from the brain so there are three basic parts of the neuron you have the dendrite the cell body and the axon the axon that's the impulse exits the neuron through the axon an axon is a projection that sends the signal from the cell body to the target tissue or other neurons so neurons may have dozens of dendrites but usually only one axon okay so let's talk about axons they may or may not be wrapped in myelin in myelin myelinated axons form the white matter in the brain the brain stem and spinal cord myelin allows the cells to transmit it signals continuously and increases the speed of conduction there are gaps between the myelated regions and they are called nodes of ranvir axons without myelin shields are termed gray matter because these axons lack the myelin sheath impulses travel slower than they would in the white matter so an axon terminal is the portion of the axon where the neurotransmitters are manufactured nerve cells are classified by the direction in which they transmit the impulses so you have the afferent which are sensory nerves impulses from the sensory receptors in the internal organs and skin to the brain and the spinal cord and then you have the efferents which are motor nerve and they carry impulses from the cns to the organs muscles and glands then you have the interneurons and they carry impulses from sensor neurons to motor neurons so synapsis and synaptic transmission dendrites and axons of adjacent nerve cells are supported by a small gap called the synapse a synapse is made up of three main parts you have the pre-synaptic plasma membrane synaptic clef and the postsynaptic plasma membrane there are two types of synapse and they're chemically or electrical most neurons use neurotransmitters to transmit their signal across the synapse to other neurons or to muscle or gland cells at the end of the axon is a presynaptic neuron or tiny bulges called synaptic knobs or synaptic terminals neurotransmitters diffuse across the synaptic cleft two receptor sites on the postsynaptic plasma membrane to which they release neurotransmitters bind so the released neurotransmitters may either be excitatory or inhibitory right so as a paramedic you may administer a variety of medicines to enhance slow or even stop these neurotransmissions transmissions of nervous impulses is what we're going to talk about next so when the cell is at its resting potential greater contractions of extracellular sodium and intracellular potassium are available they're also in the cell and it's a negative negatively charged ion chloride depolarization of the nerve cell results from opening of the sodium channels and the influx of sodium into the cell this influx creates a positive charge causing an action potential inside the cell this process creates a wave of depolarization along the nerve fiber as each cell depolarizes when stimulated by the previous neuron repolarization occurs as potassium leaves the cell and is completed when the sodium potassium pump restores sodium and potassium to the original positions as the wave of depolarization continues it eventually reaches the end of the nerve fiber at the synaptic clef the n may be the junction of the axon and dendrite of another neuron or the neuromuscular junction where the nerve impulse stimulates muscular contraction okay so",
        "The Central Nervous System": "let's talk about the central nervous system next remember you have the central nervous system and the peripheral nervous system those are the two main systems in the nervous system and the cns is responsible for the integration and coordination of sensory information and motor responses because the structures of the cms cns can be easily damaged with devastating results the body has four protective mechanisms it has the bone meninges csf and a brain blood barrier the brain has the additional protective layer called the scalp the scalp consists of the following layers so you have the hair you have subcutaneous tissue and you also have loose connective tissue and then you have the periosteum that's the dense fibrous membrane covering the surface of the bones you have bone and the bone provides physical protection for the cns and you have the meninges so they form a covering over the brain and spinal cord dura mater is the outer toughest membrane arachnoid that's the second layer pia mater is the innermost layer and they float in csf now csf is manufactured by specialized cells within the chord plexus in the ventricles and flows into that subarachnoid space between the pia mater and the arachnoid membrane you also have a blood brain barrier and that forms a barrier within the brain capillaries and extracellular fluid in brain tissue and then there's your brain it's the primary organ of the nervous system it's the control center for nearly all functions of the body there are four main areas you have this cerebrum and that's the gray matter the disease and that is composed of several structures including the thalamus hypothalamus and subthalamus then you have the brain stem and that's the controlling center for many essential functions the body requires to survive and then you have the cerebellum that's located under the cerebrum and it coordinates various activities including fine and gross muscle coordination let's talk a little bit about body",
        "Body Temperature": "temperature thermoregulation is the process of maintaining homeostasis of temperature the body's average temperature is actually maintained through a balance of gains and losses the body also has means for releasing heat the acceptance average body temperature is 37 degrees celsius or 98.6 fahrenheit body temperature regulation begins in the hypothalamus which acts as a thermostat activating mechanisms for increasing or decreasing temperature the figure on this slide shows the body's mechanism mechanisms for maintaining body temperature",
        "Limbic System": "okay so the limbic system is composed of several structures beneath the cerebral cortex with connections to other parts of the brain including the thymus hypothymus and the frontal and temporal lobes of the cerebrum the emotional brain or the feeling and reacting brain it's involved in generation integration and control of emotions and connecting them with behavioral responses motivation learning and transmission of information from short to long-term memory and functions necessary for self-preservation including response to emotional stimuli",
        "Spinal Cord": "then you have the spinal cord it's part of the cns that connects the brain to skeletal muscle tissue and skin to other structures by means of spinal nerves it exits the skull through the forum magnum and extends through the spinal column the spinal cord is encased within the cerebral canal down to the level of the second lumbar vertebra in most adults nerve fibers are arranged in specific bundles within the spinal cord to carry the messages from one specific area of the body to the brain and back okay so we've talked about the central",
        "The Peripheral Nervous System": "nervous system now let's move into the peripheral nervous system it's responsible for communication between the cns and the rest of the body there are two divisions there's the somatic nervous system it controls voluntary muscles and then there's the visceral or the autonomic nervous system and that controls involuntary and that is further divided into the sympathetic and the parasympathetic nervous systems you have spinal nerves there are 31 pairs of nerves arising bilaterally from between the vertebrae and the spine each sending and receiving sensory and motor messages to and from the cns from a portion of the body you also have nerve plexus and that's the spinal cord it combines in five areas of the body to form networks and these are called plexus where spinal nerve roots come together and transmit their impulses to areas of the body through a common nerve this allows several spinal nerves to control one area of a body you have five main plexus in the body and they're the cervical brachial lumbar sacral and the coccygeal plexus then you have cranial nerves there are 12 pairs they arise from the base of the brain all but two of them are exit the main of the brain stem and so the two that don't are the effect of factory nerve and the optic nerves cranial nerves are either referred to by their name or abbreviated as cn12 and so forth the number reflects the order in which they connect to the brain from anterior to posterior so the figure on this slide shows the 12 cranial nerves and you can see the names and the numbers",
        "Autonomic Nervous System": "the autonomic nervous system is part of the pms that is not under voluntary control there are two divisions remember in the autonomic nervous system it's the sympathetic and that mobilizes the body for activity such as the fight or flight and then there's the parasympathetic it's responsible for conserving energy and maintaining organ function counter balancing the sympathetic division so it's almost it's the rest and digest system figure shows the division of the autonomic nervous system okay so sensory function",
        "Sensory Function": "sensation is an awareness of body state or condition that results from stimulating stimulation of sensory receptors that respond to specific internal and external stimuli through sensation the pns is able to collect and relay information about the body and its external environment sensation is generated and transmitted by thousands of sensory receptors that monitor conditions inside and outside of the body the messages are generated and transmitted by sensory receptors message is processed and brought to a conscious thought it generates an autonomic response or reflex or is discarded as unimportant genera general senses are the means by which the body gathers information from its environment sensations such as pain or temperature touch or pressure are monitored throughout the body by receptors in different tissues you have the somatic and that provides sensory information about the environment and the body and then you have visceral that supply information about the body's internal organs pain receptors are sensitive to mechanical thermal electrical or chemical stimuli that could damage the body so they monitor pain you have visceral pain and that is deep pain caused by the activation of pain receptors in internal areas of the body that are enclosed within the cavity such as the chest cavity or the abdominal cavity or the pelvis somatic pain is caused by the activation of pain receptors in the body's superficial tissues such as the skin bones muscles and joints referred pain is pain perceived as occurring in one part of the body other than its true source and this frequently occurs with gi issues and then you have phantom pain and it's the sensation of pain in a part of the body that's no longer present so with limb amputation okay you have thermoreceptors and they are nerve endings that respond to heat and you have touch and pressure those monitor the changes in physical properties tactile receptors are touch and pressure receptors that are located on the skin so special senses serve as the body's first line of protection against environmental hazards you have the sense of smell and that's all faction all faction is controlled by the first cranial nerve so also known as cn1 the upper nasal cavity contains the smell receptors or olfactory olfactory cells respond to chemicals dissolved in the mucus covering these cells then you have the taste of the sense of taste that's gestation the taste buds in the mouth allow for the sense of taste taste receptors respond to four primary taste sensations and that's sweet salty sour and bitter okay now we're going to talk about the sense of sight it's conducted by the second cranial nerve or cn2 the sense of sight is facilitated by the eyes accessory structures the optic nerve and the tracks that conduct the impulses to the brain the eye has two major components and that's the optic part and it gathers and focuses light and to form the image then you have the neural part and that's the retina to convert the optic image to the neural code the eye distinguishes two aspects of light brightness and wavelength the eyeball or globe is the source of the information the brain processes into pictures okay the globe is hollow and divided into the anterior cavity and posterior cavity the globe is controlled and directed by six intrinsic muscles light passes into the globe's refractoring system which is responsible for um focusing the image onto the specialized nerve endings of the eye okay the image focuses on the retina is an upside down image and it's a miniature version of the environment in front of the eye so your sense of hearing the organs of hearing are divided into three portions you have the external middle and inner ear the external ear conducts sound to the tympanic membrane or eardrum which separates the ear canal from the middle ear the middle ear contains the auditory ossicles or three small and delicate bones that link together to transmit sound waves to the cochlea the middle end of the staples is attached to another membrane the oval window which separates the middle ear from the entrance to the cochlea which encases the primary receptor for sound the bony labyrinth protects structures of the middle ear the cochlea is a bony spiral shell-shaped containing the cochlear duct partial or complete loss of hearing is known as deafness so the sense of balance the vestibular system is contained within the inner ear and composed of a pair of fluid-filled sacs known as office and three more fluid-filled looping passageways known as semicircular channels the structures are used by the cns to collect information about movement and orientation of space semicircular canals use the movement of fluid to sense rotational movement in each of the three planes okay",
        "The Endocrine System": "now we're moving right on through to the endocrine system it's made up of glands located throughout the body the glands and hormones throughout the body to maintain homeostasis and it regulates many of the metabolic functions of the body",
        "Intercellular Communication": "intracellular communication so to maintain homeostasis the body uses many different types of chemical messengers to rely relay information to neighboring or distant cells so let's say some examples of the chemical messengers include neurotransmitters hormones ions growth factors or products of cellular metabolism most chemical messengers act on specific receptors on target cells that once they're activated trigger a series of secondary events that mediate the response of the target cells to the stimulus with endocrine communication glands or specialized cells secrete an endocrine hormone into blood that then circulates throughout the body thereby influencing tissues distant from the site of manufacture another form of intracellular communication is known as the paracrine communication so the paracrine hormones are chemical messengers that are released into circulation by one type of cell and act on a neighboring cell of a different type so an example would be the release of the ach at the neuromuscular junction",
        "Hormones": "and then you have hormones hormones are manufactured in endocrine glands they are released directly without ducts into the circulatory system they travel to specific target cells which have receptors that carry out a complex set of instructions and actions when exposed to a specific hormone each target cell that specif has specific receptor sites on the cell membrane or inside the cell to which the specific hormone can attach or bind there are three general classes of hormones and they are proteins or polypeptides amine hormones or steroid hormones hormones operate within the feedback system so it's either a positive or negative to maintain homeostasis negative feedback mechanisms are those in which the desired effect has been achieved so further action is inhibited and then the positive feedback negative are mechanisms in are those in which an effect leads to or causes another effect so examples of a positive would be the clotting cascade in childbirth an example of the negative would be a release of epi from the adrenal medulla in response to stress so you have pgs and those are prosta prostaglandins and they're not hormones but their effects are stimular or similar they are derivatives of an essential fatty acid and are called tissue hormones because their effects are usually located on or near a cell in which they are made of there are 16 different pgs and their effects are of short duration",
        "Hypothalamus": "the hypothymus that's a human body regulates itself by communicating with a cellular level through a nervous system and endocrine systems the hypothymus is the main link between the endocrine system and the nervous system it contains cells that function both on nerve cells and as glandular cells information processed by the hypothymus includes among other things it reports to the blood pressure heart rate body temperature and blood glucose",
        "Pituitary Gland": "then you have the pituitary gland it is referred to as the master gland it secretes growth hormone thyroid stimulating hormones anti-diuretic hormones and oxytoc oxytocin the pituitary gland is divided into two portions you have the anterior pituitary and it has five types of secretion cells and then you have the posterior and that secretes two hormones the adh and oxytocin are synthesized in the hypothymic normal neurons but are stored in the posterior pituitary gland okay so this figure shows the hormone secreted from the pituitary gland",
        "Thyroid Gland": "then you have the thyroid gland the thyroid gland is a large gland at the base of the neck it affects almost every body organ in the body including the nervous system cardiovascular ngi systems reproductive organs and the skin hair and nails it is critical to normal metabolism the thymus gland is located in the mediastinum just behind the sternum it functions to help the immune system identify and destroy foreign intruders during infancy and early childhood an individual's thymus is large and decreases in size as the person reaches adulthood",
        "Pancreas": "and then you have the pancreas it's an organ with both endocrine and exocrine functions in the pancreas within each eyelet of langerhan are alpha cells that secrete glucagon beta cells that secrete insulin delta cells that produce somostatin and f cells that produce pancreatic polypeptides insulin and glucagon work play an important role in maintaining a proper blood glucose balance",
        "Adrenal Glands": "and then you have the adrenal gland so the adrenal cortex produces steroidal hormones called cortisteroids which are essential to life corticosteroids among them these corticosteroids assist in the regulation of blood glucose levels they promote the peripheral use of lipids stimulate the kidneys to reabsorb sodium and exert anti-inflammatory effects during times of stress the hypothymus secretes a hormone that stimulates the anterior pituitary to release acth which causes the adrenal cortex to secrete cortisol okay and then you have the gonads their",
        "Gonads": "ovaries in women and testes in men testosterone production by the testes and the major female hormones so you have the anterior pituitary gland directs the actions of the ovaries through fsh and hormones and the ovaries produce the following so estrogen progesterone and testosterone you have the penile gland it's located",
        "Pineal Gland": "in the posterior end of the third ventricle of the brain it synthesizes and secretes melatonin a hormone that affects sleep wake patterns and seasonal functions",
        "The Circulatory System": "all right now we're moving into the circulatory system it consists of the heart and a complex arrangement of connected tubules if there are two circuits in the body you have the systemic circulation and that's when travels throughout the body and then you have the pulmonary circulation and that travels between the heart and lungs the figure shows the circulatory all right you have blood um and basically that's the process of the blood cell formation blood components and organs involved in the development of production you have bone marrow and that's the primary site and then you have lymphoid tissues and that's consisting of the thymus lymph nodes and spleen okay and then you have the spleen that filters and breaks down red blood cells it assists with production of lymphocytes and has an important role in homeostasis and infection control",
        "Functions of Blood": "there are functions of the blood if you have a respiratory function that transports oxygen from the lungs to the tissues and carbon dioxide from the tissues to the lungs you have nutritional aspect and that carries nutrients you have the excretory and that is when they ferry the waste products of the metabolism from the cells where they're produced and then excreted you have the regulatory it transmits hormones to the target organs and then the defensive and that carries defensive cells and antibodies and it protects the body against foreign organisms",
        "Blood Composition": "blood composition so the blood is primarily composed of about 55 plasma and formed cellular fragments of about 45 percent plasma is the liquid portion of the blood in which the formed elements of blood are suspended the form elements are a mixture of red blood cells white blood cells and platelets okay and then you have plasma it's 92 percent water and 7 proteins and the remainder are as oxygen carbon dioxide nitrogen electrolytes and what nutrients and waste",
        "Red Blood Cells": "red blood cells and these are the guys that carry the oxygen to the tissue there are numerous they contain hemoglobin which is the protein which carries the oxygen by binding to it and they're consistently being made of new ones their lifespans are about 120 days so common laboratory tests on blood are the red blood cell count and that's measured it measures the number of red blood cells in a sample of blood also hemoglobin levels that identifies the amount of hemoglobin found within the red blood cells and then the hematocrit and that gives the overall proportion of red blood cells in the in the blood so it's um the patient's blood is considered balanced if the hemoglobin level is one-third of the hematocrit value",
        "White Blood Cells": "the white blood cells they move through capillary walls into the tissues with right blood cells you're going to have an elevated count during an inflammatory response or an immune response or both okay so with platelets they are the key component in the formation of clots or coagulation the production is is controlled by a protein hormone and platelets circulate in the blood for about seven to ten days",
        "Platelets and Blood Clotting": "platelets and blood clotting so clotting is a chain reaction stimulated by the release of a chemical called thromboplastin from injured cells lining damaged blood vessels thromboplastin causes an inactive plasma enzyme to be converted into its active form then that's thrombin this figure shows the clotting cascade it's also called the coagulation cascade",
        "ABO and Rh Blood Groups": "all right so blood groups red blood cells contain antigens on their surface within the plasma are antibodies which react with antigens to ensure capability and prevent medical complications people are classified as having one of four blood types based on the presence and absence of those specific antigens and so the system identifies blood types of o a b and a b type o is the universal donor type a b is the universal recipient the rh factor is present in our h negative positive blood and our h factor is not present in rh negative blood and then you have the heart so that's the driving force behind the cardiovascular system it's the pump it sits in the chest above the diaphragm behind and slightly to the left of the lower sternum not much larger than the person's fists and weighs about 9 ounces it circulates 7 000 liters to 9 000 liters of blood daily you have large vessels and those vessels return venous blood from the upper and lower parts of the body to the right atrium and that is the superior vena cava and the inferior vena cava and then you have vessels that carry blood away from the heart the main ones the aorta and then you have the pulmonary arteries the figure shows the anatomy of the heart okay there are three layers that compose the wall of the heart and the epicardium that protects the heart by reducing friction you have the myocardium and it's made mostly of the cardiac muscle tissue and then the endo is made up of epithelium and connective tissue and is aligning in the continuous it's continuous with the innermost lining of the blood vessels of the body the heart chambers the heart has four chambers two atria and two ventricles the um and then there's a septum that separates the two and then you have an intra ventricular septum and that separates the right and the left ventricle so each side of the heart contains one atrium and one ventricle",
        "Cardiac Muscle": "the cardiac muscle is unique to the heart contraction occurs when calcium interferes with troponin and tryptomyosin the cardiac muscle fibers are long branching cells that fit together tightly and intracollated discs so the heart consists of two sets of chambers the atrial and the ventricular we talked about that and then you have heart valves the heart",
        "Heart Valves": "has four valves two atrial ventricular valves and two semilunar valves these valves direct the flow of blood between the chambers and prevent backflow so you have papillary muscles and that attached the um the basically the tendi and the endocardium of the ventricles and during ventricular contraction the av valves are closed because of the increase in the pressure of the chamber the sl valves separate the ventricles and their associated grape vessels these valves each have three cusps okay so the right sl valve is a pulmonic valve and the sl valve on the left is the aortic valve and this figure shows the heart valves and the cross-section of the heart valves",
        "Blood Flow Through the Cardiovascular System": "so blood throw through the cardiovascular system you have systemic circulation and that's 85 pulmonary circulation is about 10 and then the heart chambers are about 5 okay so the cardiac cycle is a process",
        "The Cardiac Cycle": "that creates the pumping of the heart systole is a contraction of the ventricular mass and the pumping of blood into the systemic circulation diastole is the relaxation phase of the cycle",
        "Heart Sounds": "and heart sounds so they're created by contraction and relaxation of the heart and the flow of the blood it's heard during auscultation with a stethoscope normal heart sound is lub dub s1 and s2 normal sounds s3 and s4 often not so abnormal sounds are murmurs or bruits clicks or snaps",
        "Cardiac Output": "cardiac output is the amount of blood that is pumped by the ventricles in one minute stroke volume is the amount of blood ejected per contraction and the heart rate is the number of cardiac contractions per minute it's also known as the pulse rate okay so preload is the volume of blood in the ventricle at the end of diastole it's a reflection of the venous return after load it's the force against which the ventricles must contract to eject the blood and there are several ways of increasing this sv okay so sterling's law that's the contr cardiac muscle when stretch it'll contract with greater force",
        "Coronary Circulation": "and then coronary circulation so it is essential for the heart to have a reliable blood supply oxygenated blood reaches the heart through the coronary arteries you have two main coronary arteries and that's the left and right coronary arteries the left coronary artery divides into the left anterior descending and the circumflex the right coronary artery travels between the right and left atrium and the right ventricle by way of the atrioventricular groove the figure shows the two main arteries and their branches on this slide",
        "The Electrical Conduction System": "and then you have the conduction system of the heart so you have electrical stimuli it's controlled by the mechanical pumping action you have the conduction system the components are the sa node the av node the bundle of hiss the right and left bundle branches and the purkinje fibers the figure shows the electrical conduction of the heart on this slide",
        "Regulation of Heart Function": "you have the regulation of the heart function so the autonomic nervous system inerts the heart by means of the cardiac nerves branches of the vagus nerves provide parasympathetic inertia and networks of sympathetic and parasympathetic fibers perform various functions so factors that includes heart the heart rate that influence it are the stimulation of the sympathetic nerves electrolyte and hormone levels metabolic rate also medication stress anxiety and fear and body temperature",
        "Blood Vessels and Circulation": "when you talk about the blood vessels and the circulation of the cardiovascular system it's the vasculature and it can be divided into the arterial and the venous systems okay so the arterial systems is blood from heart to the tissues and the venous is one that returns the blood from the tissues to the heart",
        "Arterial System": "the atrial system is the ascending aorta it originates from the base of the heart and terminates by becoming the arch of the aorta then you have the descending aorta it's named according to its location of the body cavities and then you have the aortic arch the types of arteries so you have conducting arteries and distributing arteries and then arterioles those are stop action through which blood is released to capillaries the figure shows the major veins and arteries okay so the arterial system the head and the neck you have the brachiocephalic artery it divides into the right common carotid artery in the right subclavian artery the upper extremities you have the subclavian artery it supplies both the brain neck interior chest wall and shoulder and then you have the thoracic artery and that's the visceral arteries that supply blood to the thoratic organs and then the parental arteries and they supply blood to the thoracic wall and then you have the intercostal arteries they run along the ribs and supply the chest walls you have the abdominal or aorta and basically branches of the abdominal aorta you could see on this slide in the pelvis and the lower extremities there are two common iliac arteries and they're divided into the internal iliac arteries and the external iliac arteries and they become together at the femoral arteries",
        "Venous System": "and then of course you have the vena system and those take the deoxygenated blood so back to the hearts so you have the smallest of the venous vessels they're very much smooth muscle in the middle layer venules are called storage vessels and the vena system contains about 70 percent of the blood body's blood veins adjust blood volume returning to the heart which is preload to meet the body's needs you have the pulmonary circulation and then you have the systemic circulation the head and the neck you two major veins that drain the head and the neck of blood are called the external and internal jugular veins venous sinuses are the primary means of venous drainage from the brain into the internal jugular vein so the upper um extremity you have major veins of the arm are the basilic vein and the cephalic vein you have the thorax abdominal pelvis and the hepatic portal circulation lower extremity the longest vein in the body is the great sephasius vein and it drains the foot the leg and the thigh",
        "Microcirculation": "so the microcirculation so this is the portion of the vasculature consisting of the arterioles capillaries and venules the most important functions of this microcirculation is that the transport of nutrients to tissues and the removal of cellular waste and it consists of like i said the capillaries and arterioles capillary filtration so many substances depend on the process for exchange of nutrients and waste products capillary filtration depends on three factors so the capillary membrane permeability arterial hydrostatic pressure and the venous pressure okay so the movement of water between the plasma in the intravascular compartment and the interstitial space is a result of pressure okay so you have two main forces the hydrostatic pressure and then the pressure of the osmotic pressure and it's exerted by proteins in the blood plasma",
        "The Lymphatic System": "all right so now we're moving on to the lymphatic system it's considered part of the circulatory system and it has three primary functions oval and recovery of fluid from tissues for water balance production and circulation of lymphocytes and distribution of various products unable to deliver the to the bloodstream directly so it transports lymph by passive circulation and lymph is a thin plasma-like fluid formed from interstitial and extracellular fluid that bathes the tissues of the body lymphatic capillaries pick up the lymph and drain it into larger vessels and the lymph circulates throughout the body in thin walled lymph vessels that travel close to the major arteries and veins and like veins lymphatic vessels contain valves that limit backflow foreign material is filtered from the lymph in the lymph nodes and foreign material returns to the main circulatory system via the thoratic duct movement of lymph is fluid influenced by body dynamics such as changes in respiratory pressure musculature contractions and movement of organs surrounding lymphatic vessels",
        "Lymphatic Vessels": "so when you talk about lymphatic vessels lymphatic vessels only carry fluid from the tissues and lymphatic capillaries are present in all tissues except the central nervous system bone marrow cartilage epidermis and cornea generally fluid flows from body capillaries to the tissues then out of the tissue spaces into lymph capillaries the thymus it's located in the thorax anterior to the aorta and posterior to the upper sternum it's divided into lobes by inward extending and it contains large amounts of lymphocytes including primarily an active thymocytes",
        "Spleen": "the spleen is located in the upper left abdominal cavity inferior to the diaphragm and posterior and lateral to the stomach the spleen is a largic lymphatic organ unlike the lymph nodes its venous sinuses are filled with blood not lymph",
        "The Immune System": "and then the immune system has two components the lymph node tissues and the cells that are responsible for the immune response the two primary lymphanoid tissues are bone marrow in the thymus gland bone marrow specialized soft tissue found within the bone and then you have basically the lymph node tissues and the immune cells okay so then you have glands that produce antibodies and then they bathe mucous membranes so and the saliva it fights pathogens that enter the mouth and then although these play an important role in immunity the primary cells of the immune systems of course are the white blood cells",
        "The Respiratory System": "so the respiratory system the primary function is to bring oxygen into the body and eliminate carbon dioxide the respiratory system also provides non-specific defenses against disease and also helps control ph and permits vocalization the respiratory system is composed of the respiratory tract the respiratory membrane the lungs and the diaphragm",
        "Upper Airway": "you have the upper and lower respiratory system so the upper respiratory system the structures are the nose mouth tongue jaw oral cavity larynx and pharynx and the major function of this upper respiratory system is to warm filter and humidify the air as it enters the body so we're just going to go through the upper airway and you have the first we'll start with the nasopharynx and the nasal passages and of course on the last slide we say said it was to warm filter and humidify the air when swallowing the muscles elevate the soft palate sealing off the nasopharynx from the oral pharynx this figure shows the upper airway including the oral cavity the larynx and the pharynx and then you have the oral pharynx and that begins at the level of the soft palate and extends to the epiglottitis or epiglottis the oral pharynx is the passageway for both air and food and the posterior pharynx has a rich supply of nerves stimulation of this area triggers the gag reflex the laryngopharynx extends from the epiglottis to the tip of the esophagus and for food and liquids pass through the esophagus air and other gases they enter the trachea the larynx joins the pharynx at the trachea it facilitates the passage of air functions as a sphincter and produces speech now that we've talked about the upper airway let's talk a little bit about the lower airway and so structures of the lower airway are the trachea bronchial tree and the alveoli and the lungs so the trachea connects the larynx to the lungs the bronchial tree airways leading from the trachea to the alveoli so it branches begins the right and left pulmonary bronchi each primary bronchus divides into secondary bronchus and tertiary and then even finer tubules each avlio duct ends at the alveoli respiratory exchange between the lung and blood vessels occurs in the alveoli",
        "Lungs": "and then the lungs so uh primary organs of breathing you have the right lung and it contains three lobes the left lung contains two and they're surrounded by pleura visceral pleura covers the lungs and folds back and be to become the parental pleura okay so it receives uh blood when deoxygenated blood flows from the right ventricle into the pulmonary arteries and oxygenated blood returns from the alveoli",
        "Lung Volumes": "so lung volumes movement of substantial amount of air within the respiratory system you need tidal volume and that's the amount of air moved in a single breath inspiratory reserve volume is additional amount of air that can be inhaled after the normal tidal volume has been reached and then the expiratory reserve volume and that's an additional air amount of air that can be exhaled after the normal tidal volume is expelled residual volume well that's an air that remains in the lungs to keep them open you have the vital capacity and that's the amount of air moved with maximum inspiration and expiration the autonomic dead space and that has little to no alveoli and then the uh physiologic dead space and that's damaged alveoli so the minute volume one of the critical determinants of effecto ventilation so um one basically your minute volume equals your respiratory rate and your tidal volume ventilation is a process of moving air in and out of the lungs it's two separate phases and it's inhalation and exhalation each combination of inhalation and exhalation is a respiratory cycle",
        "Inhalation": "so you have boyle's law and that is the pressure of the gas is inversely proportional to its volume negative pressure ventilation so that's drawing of air into the lungs airflow from a region of higher pressure outside the body to one of lower pressure exhalation of course is a passive process it does not require muscular effort or energy intrapleural pressure that's the pressure between the pleura of the lungs exhalation ends when the intrapleural pressure is equal to atmospheric pressure",
        "Mechanism of Ventilation": "and this figure shows the mechanics of ventilation",
        "Oxygenation": "and oxygenation so we um so this is required air used for ventilation contains an adequate percentage of oxygen so oxygenation cannot occur without ventilation but ventilation is possible without oxygenation a fraction of inspired oxygen that's the percentage of oxygen in inhaled air",
        "Oxyhemoglobin Dissociation Curve": "so oxyhemoglobin curve so oxygen saturation is portional proportional to the amount of oxygen dissolved in the plasma component of the blood the relationship between that plasma component and the sao2 or spo2 is represented by the oxyhemoglobin curve when you talk about respiration that's the exchange of gases between the living organism and its environment it provides oxygen to the body while removing carbon dioxide and it's either external or internal",
        "Internal Respiration": "first we'll talk about the external that's the pulmonary respiration and that's the exchange of gases between the alveoli of the lungs and the red blood cells traveling through the pulmonary capillaries then with internal respiration that is cellular respiration and that's when the gases exchange between the blood cells and the tissues in the bloodstream you could have anaerobic or aerobic so aerobic is oxygen and anaerobic is not containing oxygen",
        "Role of Diffusion": "so the role of diffusion it's when oxygen transfers from air into the capillaries in the alveoli partial pressure is the amount of gas in air or dissolved in liquids such as blood and it's governed by henry's law which states that as the pressure of a gas over a liquid decreases the amount of gas dissolved in the liquid will also decrease okay so the roll of diffusion it inspired air is a mixture of 75 nitrogen 21 oxygen and 0.04 carbon dioxide so what controls breathing and that's a regulation of ventilation involves a complex series of receptors and feedback loops that sense gas concentrations in the body fluids and then sends messages to the brain to adjust the rate and depth of ventilation",
        "Neural Control of Ventilation": "there are three components and these centers are in the medulla oblongata and the pons right so it functions as the integration center and there's causes of inspiration or exploration and communicates information to both ventral and dorsal represent respiratory groups there are three components you have the effectors and those are the respiratory muscles and the sensors those are the chemoreceptors and the mechanical receptors and then the pro receptors",
        "Chemical Control of Breathing": "chemoreceptors monitor variables they provide feedback to the receptorary centers basically so you have these essential chemoreceptors they're in the medulla and they respond to changes in carbon dioxide and the ph of the central or cerebral spinal fluid right and then the peripheral chemoreceptors in the carotid and aortic bodies respond to changes then you have the chemoreceptors respond to the medical conditions and traumatic injuries by stimulating respiratory control centers",
        "Lung Receptors": "you also have lung receptors and those are basically in the bronchi bronchioles and visceral pleura and they are stimulated they stimulate when lungs inflate and then you have the irritant receptors and those are airway mucous membranes and those are stimulated by various irritants and allergens",
        "Buffer Systems": "so there are buffer systems and they act as rapid defenses for acid-base changes respiratory and renal systems help maintain this homeostasis there are two major systems so we're going to move into the digestive system next you have the elementary canal and that's a series of muscular tubes that specialize along its length for processing of food and then you have the accessory digestive organs and they produce enzymes and juice is essential in the digestive process functions of the digestive system include ingestion mechanical processes digestion secretion absorption and excretion in succession different secretions primarily enzymes are added to the food by this saliva glands the stomach the liver the pancreas and the small intestines these organs convert the food into basic sugars fatty acids and amino acids the products of digestion are carried across the interstitial wall and transmitted through portal vein to the liver in the liver the products are processed further and stored or transported to the heart through veins draining the liver the hue the heart then pumps the blood with these nutrients through the arteries to the capillaries where the nutrients pass through the capillary walls to nourish the body cells the elementary channel extends from the mouth to the anus and includes the mouth pharynx esophagus stomach intestines rectum and anus okay the walls of the canal consists of mucosa submucosa muscular layer and serosa",
        "The Digestive System": "this figure shows the layers of the stomach and the layers of the intestines and this figure shows the layers of the stomach and the layers of the intestines the accessory organs of the canal include the teeth tongue saliva glands liver gallbladder and pancreas",
        "The Abdomen": "okay so the abdomen so we divide the abdomen into those four quadrants the right upper quadrant is the liver gallbladder sum of the spleen and some of the small intestines the left upper quadrant is the stomach spleen some of the colon and the small intestines the right lower is the semicolon in the appendix and the left lower is this descending parts of the colon some parts are in more than one quadrant of course these figures show the locations of the different organs in the abdomen okay so you have the oral cavity it consists of the lips cheeks gums teeth and tongue it's lined by mucous membranes you have the hard and soft palate and four teeth quadrants and the saliva glands secretes saliva with food and during mastiffication these figures show the teeth glands and the muscles of the mouth right you have the esophagus and it's a collapsible tube about 10 inches long it extends from the end of the pharynx to the stomach it transports food from the mouth to the stomach and contractions of the muscle propel food to the stomach then you have the stomach it's a hollow organ in the left upper quadrant receives food stores it and moves it into the small intestines in small amounts converts food to mixed mass and these figures show the small and large intestines then you have the small intestines it's a major hollow organ of the abdomen it absorbs about 90 percent of products of digestion into veins to transport to the liver and then the large intestines it encircles the outer abdomen around the small intestines it completes the reabsorption of water and forms solid stool to pass out of the body through the anus the liver is a complex organ with many functions and maintains blood glucose it detoxifies the blood manufactures plasma proteins and manufactures clotting factors it also regulates fats it's highly vascular organ through which 100 of the body's blood circulates the gallbladder is an basically an out poaching from the bile ducts it serves as a reservoir for bile and food triggers a release of bile from the gallbladder the pancreas has endocrine and exocrine factors and both the endocrine functions are the synthesis of glucagon insulin and somostatin and the exocrine is it produces pancreatic digestive juices when you talk about the digestion and absorption of nutrients metabolism is the sum of all chemical and biological reactions of an organism so the term is describes the rate at which the body processes the food and the body obtains nutrients by inhalation such as oxygen in ingestion such as food digestion breaks down nutrients so they can be absorbed and transported via the bloodstream and nutrients are grouped as macro nutrients and that's large amounts that provide energy such as carbohydrates and micro nutrients and those require smaller amounts and allow energy extraction from the macro nutrients such as vitamins and minerals digestion handles each of the components differently so energy from carbohydrates mostly is used to power cellular processes digestion breaks down carbohydrates into monosaccharides for easy absorption many cells get their energy by oxidizing fatty acids through neurons required continuous glucose to survive and when carbohydrates are not consumed sufficiently the liver may convert amino acids into glucose some excess glucose is changed to glycosyn and it's stored in the liver and muscles glucose can be rapidly mobilized from the glycogen but only a certain amount of glycogen can be stored so excess glucose is usually converted into fat and stored in adipose tissue and for energy the body's first first metabol metabolizes glucose then glycogen then glu into glucose and lastly fats and proteins all right so now we're into the urinary system it controls discharge of waste filtered from the bot blood by the kidneys the functions are to control fluid balance and filter and eliminate waste and then control the ph the components are the kidney ureters urinary bladder and urethra so the kidneys they regulate uh ph and volume of extracellular fluid they regulate water and electrolytes acid-base balance and products and foreign chemicals they excrete hormones and regulate arterial blood pressure and producing new glucose so there's three areas the renal cortex renal medulla and the renal pelvis about 1 million nephrons are in the kidney and then you could see what the the nephrons consist of so they basically consist of those five things okay so this capsule composed of the red corpuscle and the blood enters and the pores in the capillary walls filter that blood filtered water and waste flow from those capped from the capsule through the renal tubules so urea is the result of amino acid basically catabolism and uric acid is a result of the metabolism of certain organic bases in nucleic acids urine is about 95 water and it contains urea and uric acid urine is drained from each kidney through those tubes called ureters and um basically contractions move the urine out of the kidneys along the ureters and towards the urinary bladder once they get to the urinary bladder that's a hollow muscular sac surrounded by smooth muscle stretching of the bladder wall stimulates the nerve impulses to produce a reflex and that's an urge to void is produced by pressure in the urinary sphincter the brain keeps the external urinary sphincter contracted until conditions are favorable for urination in the urinary bladder and the urethra make up the lower urinary tract so when it comes to fluid balance there are mechanisms in the body that balance between what is taken in and out so adh allows fluid volume to build up thirst stimulates intake kidneys stimulate the excretion and the water shifts extracellular to intracellular okay so next we're going to talk about the reproductive system and um basically they're gamites which are sex cells so sperm and eggs they carry genetic instructions and the physical traits are determined by dominant and recessive genes so the male reproductive system is all these structures and the primary sex origin organs consist of two testes that's where the sperm cells and the sex hormones are formed accessory glands include vesicles prostate gland and other glands the testes produce testosterone and sperma genetic tubules for sperm cells and interstitial cells secrete the testosterone okay so on this slide you're gonna see the process of meiosis and to reach outside the body sperm cells must travel through a series of ducts and you have all the ducts listed on the slide take a look at that seminal vessels secrete a fluid that contains fructose and carbohydrates to provide energy for that sperm the prostate gland secretes fluid that enhances sperm mobility and prevents urine flow and then you have other glands that secrete mucus-like fluid lubricating the end of the penis semen is released during ejaculation and it's made up of prosthetic fluids so it's about 30 and uh vesicle fluid is about 60 and then 10 is sperm about 2 to 5 milliliters of semen is released at one time you have the external reproductive organs and that's the scrotum penis and it's the root body in the shaft which is the shaft and glands and then you have the female reproductive anatomy so you have the ovaries and they perform three functions production of the immature female basically eggs secretion of the female hormones and then secretion of the inhibition so the process of cell and egg formation it's fertilized and divides and produces a fertilized egg which is a zygote if the fertilization does not occur basically it's expelled from the uterus during menstruation okay this figure shows the follicle development and the ogenesis so the menstrual cycle menstruation is uh basically vaginal discharge of blood and epithelial cells mucus and tissue the duration of the cycle ranges from 25 to 35 days monarch is the onset of the first menses and it occurs when the girl reaches child bearing age usually between 11 and 14. menopause is the last and it occurs when a woman reaches the end of child bearing age typically about 40 to 50 years old okay and this figure shows the menstrual cycle based on the average 28-day cycle and you could see those the different days so the female internal accessory organs you have the fallopian tubes the uterus and the vagina breast and mammillary glands and then hormones okay so this completes the anatomy and physiology chapter chapter eight if you've uh liked the second part of this lecture and haven't seen the first go to part one and thank you and have a great day"
    },
    {
        "Introduction": "hello and welcome to emergency care in the streets chapter 7 medical terminology",
        "National EMS Education Standard Competencies": "after you complete this chapter and the related coursework you will understand the purpose of medical terminology be familiar with the names of the four word components used to build medical terms and be able to cite examples know the anatomic position and why it's used know the planes of the body understand the importance of accurate medical terminology and no standard medical abbreviations acronyms and symbols and which ones to avoid",
        "Introduction to Medical Terminology": "okay so let's get started as a paramedic you must develop a strong working knowledge of medical terminology international language of medicine and healthcare it's used to describe and record every aspect of patient care including medical history assessment results treatment and outcomes you should understand the origin of medical terms the components and the guidelines for firm forming words inaccurate use of medical terminology can cause administration of ineffective or harmful treatment or patient could lose trust in the paramedic's ability four effective communication and documentation you must comprehend key terms acronyms symbols and abbreviations understand medical terminology requires you to break down each word into several or separate components and have a working knowledge of these parts you also must be able to learn the accepted terms in your local area and determine if your emergency medical services systems have lists of pre-approved medical abbreviations and terms you should also have a working knowledge of common slang terms like boarding a patient for transport or bagging or tubing for airway management to expand your vocabulary to be able to deliver better care is another reason when you should understand medical terminology and so you should download the medical terminology app or download an app and carry a field guide or documentation handbook",
        "Origins of Medical Terms": "okay so let's get into the origins understanding the origins of medical terms helps you decipher the meaning of the terms most medical terms have greek and latin origins words that refer to diseases are derived from greek words words that refer to anatomic structures are derived from latin terms the table shows select terms with greek and latin origins eponyms are names of diseases devices procedures or drugs that are based on the person who invented them discovered or first described them example diesel engine is named for its german inventor ruled ruled off diesel sometimes eponyms appear in the possessive form such as hodgkin's disease or hodgkin disease often include the name of the physician or surgeon first associated in some way with them so the mcbarney point or the foley catheter the babinski reflex crohn's disease cesarean cessation or levine sign or apgar score medical terminology can use a single word to express a concept that would have taken many words for example arthritis versus inflammation of the joint homonyms are pairs of words that are produced almost the same way for example ilium it's the last anatomic portion of the small intestines versus ilium the largest bone of the pelvis good example is dysphagia which is difficulty eating or swallowing versus dysphagia which is uh difficulty speaking dysphagia incorrect pronunciation of medical terms can lead to misdiagnosis or other serious medical errors antonyms are pairs of root or word roots prefixes or suffixes that have the opposite meaning of another word and synonyms are pairs of word roots prefixes or suffixes that have the same or almost the same meaning so pneumologist versus homologists both refer to the lung and pneumologist simply has not gained acceptance",
        "Components of a Medical Term": "components of the medical term so when you encounter an unfamiliar word break it up into its components parts if you know the meaning of each part you can then combine the definitions to determine the broader meaning of the word medical terms are composed of distinct parts that perform specific functions so let's break these parts down you have the prefix and that's a portion that appears before the word root you have the suffix and that's the portion that appears after the word root the word root is the foundation of the term a combining vowel is a vowel that links one or more word roots to another component of a term the way in which the parts of a word are combined determines its meaning changing or deleting any part of the term can alter its contents accurate spelling is essential so hyperglycemia is too much blood in the glucose versus hypoglycemia is too little blood in the glucose and that is just one or two slight letters difference prefixes so common in general language such as autopilot or sub in submarine or tri and tricycle and medical and specific terminology so they appear at the beginning of the word and generally describe the location or intensity of the word root that follows and you can change the meaning of a medical term by describing the what how when or why of the word root so cutaneous means skin if you add a sub it means below the skin so subcutaneous learn to recognize a few commonly used medical prefixes so um a prefix of hypo that means low plus word root of volume plus suffix of emia and that's blood so hypovolemia means low blood volume prefix of hypo plus the word root of glyco plus an anemia so hypoglycemia is low blood glucose and then you have numeric prefixes so these are used to indicate the number of sides limbs or sensory organs affected all right so an example is monocular vision sample of a numerical prefix is time so octogenarian is a person between 80 and 89 years of age suffixes so components added to the ends of the word roots that change and add to its meaning the words meaning or provide further definition so in medical term a suffix usually specifies a procedure conditioned disease or a part of a speech a's indicates an enzyme and lip is fats so lip plus ace lipase is an enzyme enzyme that digests fats suffixes are able to change the medical term to a noun or adjective as needed so now let's talk about word roots it's the main part of the word sometimes called the root word it establishes establishes the essential meaning of the word and frequently indicates a body part prefixes are added to the beginning of the word roots suffixes of course as we said earlier are added to the ends and changing the prefix or suffix will change the meaning of the term consider the context of the word before assigning its meaning the same word root may have different meanings in different fields of studies here are several word roots that describe color and that's table 7-5 combining forms and vowels so some word roots prefixes and suffixes cannot combine with other forms without help okay so sometimes it's necessary to change the last letter or the last few letters of the word root or a prefix to ease pronunciation when the suffix is added combining valves facilitate the formation of new more complex terms often it consists of an o added to the word root so combining form so word root prefix or suffix with an added vowel is a combining vowel an example of this would be osteopathic so the word root is osteon osteo plus pathic so bone plus disease right example another example is a gastromegaly so the word root is gassed right and then of course we add that o onto it so that makes a gastro and then megaly right and so that's the stomach and it's irregular enlargement the suffix begins with a vowel a combining vowel is not needed so gastric so you see it's an ic um and so then um the o is not needed following these guidelines when adding combining vowels to root words so use a combining valve before a subset suffix that begins with a consonant so uh cytology right so you see the cytology use a combining vowel to join other word roots example gastroenteritis do not use a combining vowel before a suffix that begins with a valve so you have gastritis versus gastro o e itis common combining forms and valves so um common is the lology so the study of okay so cardiology or neurology so the study of the heart or the study of the nervous system",
        "Compound Words": "okay we're going to talk about compound words next so compound words contain one contain more than one word root each word root contains its basic meaning so simple examples containing two word roots are electrocardiogram or thermometer more complicated um words are ostoarthritis so ost is bone and arthro means joint or joints and itis is inflammation so osteoarthritis means inflammation of the bone joints",
        "Plural Endings": "and now we'll talk about plural endings so to change a term from singular to plural form there are certain rules that apply sometimes you can simply add an s lung becomes lungs but some rules are more complicated singular words that end in an a change to an ae when plural example vertebra becomes vertebrae singular words that end in is changed it to es when plural example diagnosis becomes diagnoses singular words that end in an ex or ix change to i i-c-e-s blood this is apex becomes apices singular words that end in o n or um change to a examples is gate ganglion becomes ganglia or ovom becomes ova singular words that end in u.s change to eye so an example is bronchus becomes bronchi",
        "Topographic Anatomy": "so let's talk about some topographic anatomy so there are superficial landmarks on the body that serve as guides to the structures that lie beneath them taken together these features make up the body's topography familiarize yourself with the landmarks to perform a thorough assessment imagine the body in the anatomic position to describe topography accurately and so the person in an anatomic position is standing facing you arms to his or her sides with palms facing forwards thumbs point away from the body okay the position is a shared reference point so the meaning of various directional terms stays consistent regardless of the body position or movement",
        "Anatomic Planes and Axes of the Body": "so let's talk about some planes and axises of the body so you have the anatomic plane of the body and that's an imaginary flat surface dividing the body horizontally and vertically into sections an axis is an imaginary line that divides the body equally and creates a point of rotation so there's a great photo on this slide and we're going to talk about these different planes and accesses okay so the body is divided along three main axises to create the following planes we have the coronal plane and that slices the body vertically from ear to ear dividing it into front which is ventral and back which is dorsal portions also called the frontal plane cornea corner means head then you have the transverse plane this passes horizontally through the body at the waist it creates a top and bottom portions it's also called the axial plane then you have a sagittal plane um it's also called lateral plane and it divides the body vertically slicing it from front to back also called the lateral plane sagitta is latin for arrow midsagittal plain it's the midline and it divides the body into equal left and right halves your nose and navel are found along this imaginary line three axises along which the body can be divided are you have the antroposterior axis and it runs perpendicular to the corneal line or plane and you have the longitudinal axis it runs perpendicular to the transverse plane and then you have the horizontal axis and it's also called the medial lateral axis and it runs perpendicular to the sagittal plane these planes and axises help to identify the location of internal structures so understand the relationships between and among the organs a cross section slicing across an object perpendicular to the long axis as you would do if you wanted to count the rings of a tree trunk a longitudinal section is a view of an object cut along the long axis so this is accomplished with a camera or a beam of radiation",
        "Specific Areas of the Body": "so let's get into specific areas of the body so many body areas have specific names familiarizing yourself with the body region will help you to understand help you communicate with other professionals and break down other terms an example of this is the sternocleidom clydomastoid a combination of sterno clydo and mastoid which refers to the sternum clavicle and mastoid process if you understand the roots you will be able to locate the origin and insertion of the large neck muscle the table on this slide shows terminology associated with specific body regions it's also in chapter 7 and it's a table eight so 7-8 and then on this table you're going to also see some terminology associated with body specific regions",
        "Body Cavities": "okay next we're going to talk about body cavities so the human body cavities contain various organs and other structures these cavities can be grouped into two categories you have the dorsal and that's the posterior and then the ventral that's the anterior the dorsal cavities are the posterior cavities i also i always think of dorsal fin like as if on a dolphin you have the cranial cavity and it contains the brain and the spinal cavity that surrounds the spinal cord you have ventral cavities um those are anterior the thoracic cavity encloses the heart lungs and great vessels you have the abdominal cavity and that holds several digestive and endocrine organs then you have the pelvic cavity that contains digestive organs and female re reproductive organs the abdominal and pelvic cavities can be referred to together as the abdominal pelvic cavity the retroperitoneal cavity is separate from and lies posterior to the abdominal cavity and contains different organs most notably the kidneys so this is a really good slide and it shows the body cavities okay so next we're going to talk about directional terms and you use these to describe relative positions of body parts and imaginary anatomic divisions so use these correct directional terms to describe the location of pain or an injury and so this figure shows common directional terms and let's talk about them now so directional terms in medicine tend to occur in pairs because every direction has an opposite direction so superior and inferior lateral and medial proximal and distal superficial and deep anterior and posterior and palmar and plantar and apex so we're going to go through those individually in the next couple slides okay you have the superior versus the inferior so superior is a part of the any body part in which the portion is closest to the head so superior obviously just what it sounds like closest to the head so the part closest to the feet is inferior and also used to describe the relationship of one structure to the other so example the knee is superior to the foot and inferior to the pelvis the next directional term we're going to talk about is lateral and medial okay so parts of the body that lie further away from the midline are described as lateral outer the parts that lie closer to the midline are described as medial or inner example the knee has medial and lateral aspects proximal and distal so proximal describes structures that are closer to the body and we talk about this when we talk about the trunk so such as a fracture to the proximal humerus would involve the end of the bone that is closest to the shoulder and distal indicate structures that are farther away from the trunk or nearer to the free end of the extremity and fracture to the distal humerus is one that involves the end of the bone further from the body so we use these terms to describe relationships of one structure to another and usually what i i think of is that we use them for the appendicular skeleton right superficial and deep of course superficial means closest to the surface of the skin deep is farther inside the body and away from the skin anterior and posterior so we talked a little bit about that so anterior or ventral refers to the belly side posterior or dorsal refers to the spinal side of the body including the back of the hand in human medicine use anterior and posterior ventral and dorsal are used in other sciences okay and then palmer and plantar the front region of the hand is referred to as the palm or palmer surface and the bottom of the foot is referred to as the plantar surface and then apex the apex or pleural apices is the tip of the structures so example the apex of the heart is the bottom or inferior portion of the ventrals in the left side of the chest",
        "Movement and Positional Terms": "all right now that we've gone through some directional terms now we're going to move on to movement and positional terms all movement can be broken down into simple components and described with specific terms and accepted set of terms describes body movement so particularly useful in explaining mechanism of injury range of motion is the full distance that a joint can be moved so we use that term range of motion and these are the common um movement and positional terms so first we're going to talk about flexation so when you're moving the distal point of the extremity towards the trunk while in the anatomic position examples you flex the elbow and it brings the hand closer to the shoulder so flexation of the knee brings the foot up to the buttocks dorsiflexion is the movement of the foot towards the dorsal aspect plantar flexation is the movement of the foot towards the sole extension is the return of the body part from the flex position to the anatomic position abduction is the movement a way from the midline and adduction is the movement towards the midline they use that um enunciate the the beginning of it right because so so ab is a way add is towards and then a patient's neck can be in one of several positions when found when you find the patient laying supine right so the neck we refer to you could use the prefix hyper and this is added to the terms flexation or extension to include the mechanism of injury so hyper indicates a normal range of motion for a particular joint was maximized or overextended such as hyperflexion right so maximum flexion or flexion beyond the normal range of motion an example would be a hyperflexion injury of the back can occur when bending or hyperextension is a maximum extension or extension beyond the normal range of motion so example would be an injury that occurs when a person falls on an outstretched hand this results in a distal radius fracture wrist injuries can also be described using the terms sublimation or pronation so sublimation is turning the palms towards the sky upward or towards the sky pronation is turning the palms downward towards the ground and then there's rotational deformities so an internal rotation is a turning the anterior portion of the extremity towards the midline and an external rotation is turning the extremity away from the midline so rotational deformities are noted when comparing an injured extremity to an uninsured extremity so hips can be dislocated anteriorly or positionally or posteriorly the term rotation can also be applied to the spine",
        "Other Directional Terms": "and then there's other directional terms that are very common that you'll hear often and a term like bilateral is a body part of condition that appears on both sides of the midline so you can have ears eyes feet hands structures inside the body also appear on both sides of the midline such as lungs and kidneys then you could you'll hear a term unilateral and that's something that appears on only one side of the body so an example is the spleen is only on the left side of the body it's unilateral unilateral and bilateral can also describe the location of pain numbness itching or another phenomena so contralateral refers to the opposite side of the body an ipsilateral refers to the same side of the body you must be able to describe the exact location of areas in the abdomen so the abdomen is divided into four quadrants and you could see that on the slide and the right upper quadrant left upper quadrant right lower quadrant and left lower quadrant the quadrants are formed from two lines intersection at the umbilicus again right and left refer to the patient's right and left not ears and then to describe even more specifically the abdomen can be divided into nine regions okay so prefixes indicating position direction and location so they're specialized pre-lit fixes and they are used to specify position direction and location these terms can describe movement of the body or something within it so like a blood clot or a tumor how it metastasizes the location of organ foreign body or mass or surgical procedures and medical instruments used to perform them and direction of radiation or ultrasound waves",
        "Position of the Patient": "and then there's the position of the patient so we use specific terms to describe the patient's position and the you'll hear the term prone if a patient is laying face down supine is a position when the patient's laying face up fowler's position is a patient sitting straight up with his knees bent or straight and then semi fallers is when the patient sits up at a 45 degree angle generally a position of comfort for those who do not need spinal immobilization and then a very common position of the patient that you're going to hear is called the recovery position this helps maintain a clear airway in an unresponsive patient and prevents aspiration and vomitus a patient is lying on his or her left side with the head resting on the bottom arm the knee is bent angling the front of the patient's body slightly towards the floor or ground also referred to as left lateral recumbent position and this figure shows the anatomic position so this is great so you have um uh basically supine prone and then the recovery position",
        "Abbreviations, Acronyms, and Symbols": "all right so then you're going to have abbreviations acronyms and symbols and medical abbreviations acronyms and symbols are a type of shorthand that's used to communicate in the medical world so it's developed to allow us to communicate faster do not trade speed for accuracy though use only commonly understood acronyms and abbreviations to minimize misinterpretations and errors all acronyms are abbreviations but not all abbreviations are acronyms okay so when you use the abbreviation pronounce each letter of the abbreviation separately and distinctly for the abbreviation e m t say e m t acronyms for shorthand words from the initials of several words are produced a new word or phrase so an example of urban search and rescue becomes usar an abbreviation is still considered an acronym if it is pronounced as a word even if the word is formed isn't part of the english language example is hipaa so the health insurance portability and accountability act is an acronym because it's pronounced as hipaa example dea is not an acronym because it isn't spelled out like dea medical abbreviations take the place of words to shorten documentation some acronyms have become a common part of the english language so an example is asap for or asap force as soon as possible so ensure that medical abbreviations you use are consistent with those approved in your ems system because there are error-prone abbreviations so the joint commission and the institute for safe medication practices have each published a do not use list serious errors can occur when an abbreviation is not interpreted as intended hs on a prescription can mean either hours of sleep or half strength to avoid errors some agencies limit the use of abbreviations and do not allow their use so trailing zeros and naked decimals so trailing zeros is zero offer the decimal point so zero's after the decimal point sorry to avoid errors always include a zero before the decimal but leave it off after so write five milligrams not 5.0 milligrams and 0.5 milligrams not 0.5 okay so the next thing we're going to talk about is syllables and like abbreviation syllables are sometimes used as a shortcut in documentation and other communication so as with abbreviations though it's important to only use syllables that are widely understood and accepted syllables that can easily be confused are the greater and greater than or less than and it may be mistaken for the numbers seven or the letter l or each other so spell out the syllables that may be misinterpreted to protect patient safety the joint commission requires every hospital to issue a list of approved abbreviations and certain abbreviations are prohibited so each ems system should also list keep a list of approved medical abbreviations available for reporting and documentation purposes learn which abbreviations are acceptable in your service area and when in doubt write out the term in full and this table shows some common syllables",
        "Medical Terminology Related to Pharmacology": "so medical terminology related to pharmacology so a paramedic must be familiar with terminology related to medications and medication administration such as prefixes commonly used in medication administration metric conversions used in drug calculation and selected medical abbreviations associated with pharmacology so there's a master table um tables 7-15-7-8 provide reference lists of selected prefixes suffixes word roots and combining forms and other common abbreviations these tables show prefixes commonly used in medication administration and metric conversions used in drug calculations and this table shows selected medication or medical abbreviations associated with pharmacology okay so this concludes chapter 7 medical terminology lecture if you've enjoyed this go ahead and subscribe to the channel because we're going to be producing all the chapters very shortly thank you"
    },
    {
        "Introduction": "hello and welcome to the emergency care in the streets chapter 9 pathophysiology after you complete this chapter you will have an understanding of cellular changes in response to stressors the understanding of what happens when the cellular system can no longer maintain homeostasis is a key component of patient evaluation and treatment",
        "Pathophysiology": "the human body is made up of cells tissues and organs biology is the study of living organisms with regard to their origin growth structure behavior and reproduction pathophysiology is the study of the functioning of an organism in the presence of disease it's derived from greek words meaning pathos is comes from suffering and physicists from form when the condition or functioning of a cellular system breaks down in response to stressors and homeostasis can no longer be maintained disease can grow understanding the cause of the disease process can help in evaluation and treatment to understand how disease may alter cellular function you must understand normal cellular structure and function when exposed to adverse conditions cells undergo a process to attempt to protect themselves from injury change can be permanent or temporary the word atrophy means a decrease in cell size due to a loss of subcellular components it leads to a decrease in the size of the tissue and organ the actual number of cells remains unchanged the decreased size represents an attempt to cope with a new steady state with less than favorable conditions hypertrophy is an increase in the size of the cells due to synthesis of more subcellular components this leads to an increase in tissue and organ size hyperplasia is an increase in the actual number of cells in an organ or tissue usually results in an increase in size of an organ or tissue dysphalesia is an alternation in the size shape and organization of cells most often found in epithelial cells that have undergone irregular atypical changes and then metaphlasia is a reversible cellular adaptation in which one adult cell type is replaced by another human body is composed primarily of water all biochemical reactions occur in an aqueous environment homeostasis can be upset by excessive output or input of fluids such as sweating salt intake or dehydration the average adult takes in about 25 hundred milliliters of water a day or 2.5 liters 60 from drinking another thirty percent from water and foods and the remaining ten percent is a byproduct of cellular metabolism most water is lost in the form of urine which is sixty percent twenty eight percent is lost through the skin and lungs and six percent is lost through feces the degree of fluid imbalance required to compromise homeostasis and cause illness depends on the patient's size age and underlying condition cellular environment changes with aging exercise pregnancy medications disease and injury body fluids can body fluids contain water sodium chloride potassium calcium phosphorus and magnesium plus some other substances the body weight is approximately 50 to 75 percent fluids average male is 60 fluids average female is 50 fluids intracellular fluid is 45 of the body weight an extracellular fluid is 15 of the body weight interstitial fluid is extracellular fluid surrounding tissue cells including cerebral spinal fluid and synovial fluid intravascular fluid is extracellular fluid found within the blood vessels but outside the cells okay let's talk about some disturbances so um first one we're going to talk about is edema and this occurs when excessive fluid builds up in interstitial space you could have peripheral edema and that's in the ankles and feet and is most common form of edema you could have severe edema and it may be caused by long-standing lymphatic obstruction and you could have sacral edema and that may occur in bedridden patients or you could have ascites and that's an abnormal accumulation of fluid in the peritoneal cavity okay and it may be because of several causes so you could have an increased capillary pressure which is from some type of venous obstruction or increased vascular volume you could have pre-menstrual sodium retention pregnancy environmental stress or effects of gravity for prolonged standing okay and then there's decreased osmotic pressure in the capillaries and this is from decreased production of plasma proteins or increased loss of plasma proteins you could also have lymphatic vessel obstruction due to infection or disease of the lymphatic structures or removal of lymph nodes you could also have clinical manufa manifestations and it may be local or generalized you could have pulmonary edema for cardiac reasons or following near drowning incident or overdose when we talk about assessment of edema we want to make sure that we perform an in-depth assessment of including auscultation of breast sounds evaluation for pedal edema and jugular venous distension ekg of course and vital signs and we want to determine a patient's medical history and current and past medications treatment may include diuretics nitrates continuous positive airway pressure which is cpap high flow 2 and advanced airway placement okay so change in water contents can cause a cell to shrink or swell tonicity is the tension exerted on a cell due to water movement across the cell membrane in isotonic solution cells neither shrink nor swell in hypertonic solution water is pulled out of the cells and they shrink in hypotonic solution cells swell isotonic fluid deficit what will happen is you'll have a decrease in extracellular fluid with proportionate losses of sodium and water in an isotonic fluid excess you'll have a proportionate increase in both sodium and water in the extracellular fluid compartment causes of this include kidney and heart and liver failure when dehydration exists orthostatic hypotension so low blood pressure and decreased urine output are common when sodium level is very high hyperthermia delirium and coma may be seen okay so when we talk about sodium the normal serum sodium levels are 136 to 144 okay hyper tonic fluid deficit caused by excess body water loss without a proportionate sodium loss results in hypernatremia which is serum sodium level greater than 145 hypotonic fluid deficit caused by excessive sodium loss with less water loss results in hyponatremia which is serum sodium levels less than 30 135 okay so when we talk about potassium that's necessary for uh neuromuscular control regulation of three types of muscles acid-base balance intracellular enzyme reactions in maintenance of intracellular osmolarity so the normal serum potassium levels are 3.5 to 5. hypokalemia is decreased serum potassium levels and its common cause include decreased potassium intake our potassium shifts into the cells renal potassium losses and extra renal potassium losses frequent complaints include muscular weakness fatigue and muscle cramps the ekg shows decrease and broadening of t waves when you have hyperkalemia this is elevated serum potassium levels it's common causes and cli include there's many causes such as decrease excretion an example is renal failure and shifts of potassium from within the cell such as with burns and excessive intake of potassium this may lead to muscle weakness and flaccid paralysis ekg changes include peaked t waves widening of qrs complex and dysrhythmias and it can be life-threatening calcium administration intravenously immediately antagonizes cardiac conduction abnormalities and bicarbonate insulin and albuterol work in a 15 to 30 minute period okay and then we next we'll talk about calcium and the majority is found in bones and in teeth it provides strength and stability for the collagen and ground substance forming the matrix of the skeletal system it's absorbed from the intestines in a process that depends on the presence of vitamin d so normal serum calcium level is 8.5 to 10.5 when it's low it's called hypocalcemia this is a decrease serum calcium level it can be caused by decreased intake or absorption or increased loss such as with alcoholism endocrine disease and sepsis and symptoms may include spasm of skeletal muscles causing cramps and tenacity laryngeal spasms and seizures when you have too much calcium it's hypercalcemia and this is increase in serum calcium level its cause causes include increased intake or absorption and then such as excess anti um antacid ingestion endocrine disorders and miscellaneous causes so symptoms include constipation or and frequent urination which is polyuria you could have stupid coma and renal failure may develop in severe cases okay so next we're going to talk about phosphate and this is intracellular and on essential too many functions so hypophosphate anemia is a decrease in serum phosphate levels it's caused by decreased supply or absorption excess loss of phosphate such as using diuretics so intracellular shift of phosphate such as after administration of glucose or an extra electrolyte abnormalities and abnormal losses followed by inadequate replication such as diabetic ketoacidosis can cause that okay symptoms include muscle weakness decrease deep tension reflexes and some confusion treatment involves oral replenishment or iv phosphate replacement and then the next one we're going to talk about is high so this is hyper hyperphosphate anemia this is increase in serum phosphate levels it's caused causes include massive loading of phosphate into the extracellular fluid such as excess vitamin d and excretion into the um into the urine such as with renal failure so symptoms may include tremors or paresthesia confusion seizures muscle weakness stupercoma hypotension or heart failure and also a prolonged qt interval the next thing we're going to talk about is magnesium so is the second most abundant intracellular cation it's normal range of serum magnesium is 1.5 to 2.1 hypomagnesia is a decrease in serum magnesium level it's caused by diminished absorption or intake increased renal loss and miscellaneous causes such as diabetes or respiratory alkalosis common symptoms include weakness muscle cramps and tremors treatment causes consists of iv fluids containing some magnesium okay so hyper magnesia is the next thing that's an increased serum magnesium level it results from kidney insufficiency and the inability to excrete the amount of magnesium that you have taken in symptoms include a muscle weakness decreased depth or deep tendon reflexes and confusion okay so when you start talking about",
        "Acidbase Balance": "disturbances of the acid-base balance understand that acid and bases neutralize each other and must remain in balance acidosis is an increase in extracellular hydrogen ions and alkalosis is a decrease in extracellular hydrogen ions disturbances of acid-base balance are associated with disturbances in potassium balance okay so kidney transport system moves hydrogen and potassium in opposite directions acidosis then is it you excrete hydrogen and reabsorb potassium alkalosis you excrete potassium and reabsorb hydrogen okay so calcium ions also shift in response to the influx of hydrogen a high serum calcium level decreases the rate of of neural transmission a low cerium calcium level leads to hypersensitive neurons and an accelerated rate of neural transmissions okay so types of acid-base disorders so fluctu fluctuations in ph due to bicarbonate levels result in metabolic acidosis or alkalosis fluctuations in ph due to respiratory disorders result in respiratory acidosis or alkalosis when an acid-base disorder is not immediately corrected by the body's buffering system the body initiates compensate compensatory mechanisms patience management often involves treating more than one form of an acid-base imbalance so there are four main clinical presentations of this acid base in balance and the first one we're going to talk about is the respiratory acidosis okay so respiratory acidosis is always related to hypoventilation it's a compensatory mechanism is the renal buffer system and its causes include airway obstruction cardiac arrest overdoses or central nervous system presence near drowning respiratory rest pulmonary edema closed head injury chest injury and carbon monoxide there's a wide range of it reasons hypoventilation can quickly develop a potentially fatal acidosis making it possible for the slow reacting renal system to compensate so what happens are signs and symptoms include systemic or cerebral vasodilation including headaches red flesh skin central nervous system depression braided nausea vomiting and hyperkalemia so chronic obstructive pulmonary disease creates a respiratory acidosis over time gradual destruction of the lung tissue inhibits the exchange of oxygen and carbon dioxide when you have copd so the hypoxic drive is then the only remaining stimulus for breathing so slow onset of this form of respiratory acidosis makes it survivable when you have copd so the second type of",
        "Respiratory Alkalosis": "acid-base disorders we're going to talk about is respiratory alkalosis and so it's always caused by hyperventilation it's life-threatening events may be responsible for hyperventilation so what happens is carbon dioxide levels drop in the blood forcing a reduction in the circulating carbonic acid so the renal system begins to retain hydrogen ions to to rebalance the shift so then calcium shifts into the intracellular fluid to rebalance the depletion of hydrogen ions the resulting hypocalcemia causes muscle contractions causes of hyperventilation and respiratory alkalosis include drug overdoses especially aspirin some fevers and overzealous back mass ventilations can cause hyperventilation okay so when it comes to respiratory alkalosis signs and symptoms include diminished loss of conscious or level of consciousness lightheadedness carpal pedal spasms tingling lips and face chest tightness confusion vertigo blurred vision hypocalcemia and nausea and vomiting so the third type of acid-base disorder is a metabolic acidosis and then of course the fourth one is metabolic alkalosis so we'll talk about acidosis first and uh it's caused by any acidosis not related to the respiratory system so there could be increased respiratory respirations and a compository mechanism for this condition however um an example would be diabetic ketoacidosis and cushmal respirations which will increase that respiratory rate to try and compensate but um so hydrogen leaks out of the cell and serum potassium shifts into the extracellular space raising the cerium potassium levels calcium also shifts into extracellular space causing hyperkalemia or hypercalcemia which obstructs impulses of neurons in muscles and other tissues yeah causes include when it comes to metabolic acidosis you have cause lactic acidosis caused by cellular respiration anaerobic cellular respiration ketoacidosis caused when cells metabolize fatty acids for energy because they are unable to get used glucose so the byproduct of fat metabolism is ketones it combines or compounds that are extremely acidotic also aspirin overdoses uh aspirin directly stimulates the respiratory center in the brain causing uh tachypnea which leads to respiratory alkalosis so um fast respiratory rate that leads to respiratory alkalosis also alcohol ingestion leading to alcoholic ketoacidosis then you have gastrointestinal loss so signs and symptoms include vasodilation central nervous system depression headaches hot flush skin hypercalcemia tachypnea nausea and vomiting and cardiac dysrhythmias okay",
        "Metabolic Alkalosis": "and then the next one and final we're going to talk about is the metabolic alkalosis this occurs when there is an excessive loss of acid from increased urine output or decreased acid level in the stomach so common among chronically ill patients causes include upper gi losses of acid such as illness or eating disorders drinking large amounts of water during vigorous exercise or excessive intake of alkaline substances such as antacids compensatory mechanisms in the respiratory system so you could have slow respirations as a means of retaining carbon dioxide increasing the level of circulating acid also signs and symptoms include confusion muscle tremors and cramps and hypotension okay so cellular injury is what we're",
        "Cellular Injury": "going to talk about next and it there's various causes hypoxia ischemia chemical injury infectious injury immunological injury so physical damage and inflammation some type of inflammatory injury so manifestations and death depend on how and how many and which types of cells are damaged so it can occur at both a microscopic and functional level so common microscopic abnormalities include cell swelling rupture of cell membranes or nuclear membranes and breakdown of the nuclear material and often results in a change in cell shape and function so functional changes may include an inability to use oxygen appropriately develop of extracellular acidosis accumulation of toxic waste products and an inability to metal metabolize nutrients damage and functional changes in cells often have an impact on the entire organism the entire organ system may fail and dysfunction in one system inevitably affects the other systems repair can occur up to a point with proper treatment so irreversible injuries irreversible injuries will lead to cell death cell death is followed by necrosis and that's a process in which the cell breaks down cell membranes become abnorm abnormally permeable and the cell and its organelle swell okay so the first cell injuries we're going to talk about the cause is this hypoxic injury and it's common cause of cellular injury it's often deadly it may result in decreased amounts of oxygen in the air or loss of hemoglobin function it's a decreased number of red blood cells or disease of the respiratory or cardiovascular system so cells that are hypoxic for more than a few seconds produce mediators that damage other local or distant body locations a positive feedback cycle leads to more cell damage and more hypoxia the earliest and most dangerous mediators are free radicals what free radicals do is they're molecules missing one electron in their outer shell so this results in chemical instability and it causes random attacks on other cells and membranes and it results in widespread and potentially deadly tissue damage so the second type of injury",
        "Chemical Injury": "we're going to talk about is a chemical injury and this is common with poisons so cyanide will induce cell hypoxia by blocking um basically the mitochondria and preventing the metabolism of oxygen when it comes to pesticides they block an enzyme present preventing proper transmission of nerve impulses and then also with lead chronic ingestion leads to brain injury and some neurologic dysfunctions it mistaken for calcium in vital biochemical reactions leading to abnormal results and dysfunctions okay and then there's carbon monoxide carbon monoxide binds to hemoglobin it prevents adequate oxygenation to the tissues and this uh causes low levels of oxygen in the body so at low levels though it will cause nausea vomiting and headache higher levels will result in death and then ethanol the lower levels will cause some inebriation but higher doses results in severe central nervous system depression hypoventilation and cardiovascular collapse and then pharmacologic agents produce toxic products when metabolized in the body especially in overdose conditions so that's the chemical injuries okay so the next uh injury we're going",
        "Infectious Injury": "to talk about is the infectious injury and infectious injuries to cells occur as a result of an invasion of bacteria fungi or viruses so bacteria can cause injury by a direct action on the cells or the production of toxins that causes the injury the viruses can initiate an inflammatory response this leads to cell damage and the symptoms that you're going to see in the patient then you have brilliance that's measures the disease causing ability of the microorganism and the pathogenicity is the function of the organism's ability to reproduce and cause disease within the human body growth and survival of bacteria in the body depend on the effectiveness of the body's own defense mechanisms the bacteria's ability to resist those mechanisms so newborn infants older adults and people with diabetes and people with cancer or other chronic diseases tend to have weaker immune systems so let's get a little bit more in depth",
        "Bacteria": "and break them down so first one we're going to break down is bacteria and many possess a capsule that protects them from ingestion or and destruction so phagocytes are cells that engulf and consume for materials so categorize depending on the results of gram staining gram staining is a suspension of bacteria is stained with a purple dye and then an iodine solution so um then discolorized with alcohol and other solvent then stain with red dye so bacteria that resist discoloration are called gram-positive bacteria bacteria that accept the color stain are called gram-negative bacteria and so what happens are they produce exotins or endotem toxins sorry exotoxins or endotoxins that can injure or destroy cells so exotoxins are produced within the cell and released into surrounding tissues or fluids they're poisonous they actions vary inactive exotoxins are sometimes used for vaccines then you have endotoxins and they are lipo polysaccharides that are part of the cell walls of gram-negative bacteria so they cause inflammation fever chills and malaise they may cause septic shock if present in large amounts and they re remain active even after the bacteria is destroyed this is the body's most common reaction to the presence of bacteria is inflammation and then we need to talk about viruses",
        "Viruses": "so intracellular parasites that take over uh the metabolic process of the host cell and use the cell to help them replicate they consist of nucleic acid core of either rna or dna and capsaice is a layer of protein that protects the virus from phagocytosis so replication occurs inside the host cell a symbolic relationship symbionic relationship between the virus and the normal cells may be the cause of a persistent unapparent infection the next one we're going to talk about",
        "Inflammation": "is the immunologic and inflamma inflammatory injury so inflammation is a protective response that can occur with even without bacterial invasions so you could have an infection it's characterized by an invasion of microorganisms that cause cell or tissue injury leading to an inflammatory response and it can be triggered by an agent that is physical chemical or micro biologic so local effects include dilation or expansion of the blood vessels and increase vascular permeability okay so signs include heat redness tenderness swelling and pain and then of course the outcome depends on the amount of tissue that's damaged so you could have a mild inflammation that results in a return to normal tissue or more severe inflammation results in destroyed tissues that must be repaired so you could have scar tissue replaces large areas of tissue destruction okay so now the next injury factor that",
        "Genetic Factor": "we're going to talk about is the genetic factor and so genetic factors that may damage cells include chromosomal disorders or premature developmental development of atherosclerosis or obesity sometimes and then you have an abnormal genes may develop and if a gene mutates during meiosis it can affect newly formed fetuses by hereditary you can have genetic factors that cause injuries or due to some other later cause in life so examples of diseases with genetic link include down syndrome and rheumatoid arthritis okay and then you have injuries which are related to nutritional imbalances and so um of course good nutrition is required to maintain good health and assist the cells in fighting off diseases but injurious nutritional imbalances include obesity or malnutrition or some type of vitamin or vitamin access or excess or deficiency or mineral excess or deficiency these conditions can lead to alterations in physical growth mental and intellectual retardation and death and then you have physical agents or conditions that can cause injuries and so these include heat cold or radiation and they may cause injury by burns frostbite radiation sickness and tumors the degree of the cell injury is determined by this the strength of the agent and then the length of the exposure",
        "Apoptosis": "okay so the next injury we're going to talk about is apoptosis and this is basically normal cell death and so basically cells are genetically programmed and as part of the normal development uh immune function and tissue grows the cells exhibit characteristics of nuclear changes and dye in well-defined clusters and so what happens is it's a basically activation of genes that are encoded for proteins known as capsasis eventually leads to cell suicide it's controlled degradation allows their remnants to be taken up and reused by neighboring cells but it can be prematurely activated by pathologic factors such as cell injuries some forms of heart failure can result in early cell death death of liver cells in patients with viral hepatitis you could see this happen and the inhibition of normal function allows destructive cellular proliferation so such as with cancer or rheumatoid arthritis you can see that occur and then the last injury we're going to talk about is abnormal cell death and necrosis that results of the changes that occur following cell death and living tissue so you have simple necrosis and basically areas of necrosis where the gross or microscopic tissue and some of the cells are recognizable and it may be caused by acute ischemia acute toxicity or a direct physical injury and then you have derived necrosis the causation necrosis manifested by the loss of all features of tissue and cells so you could have some dry gain green that results from invasion or precipitation of necrotic tissue after the blood supply is compromised fat necrosis and that results from the destruction of fat cells usually by enzymes and then liquefication necrosis and that results from coagulation necrosis followed by conversion of tissue into a liquid form and invasion of putrifying bacteria okay so the next area we're going to",
        "Hypoperfusion": "talk about with the pathophysiology is going to be hypoperfusion now hyperperfusion is the major major thing that you're going to be dealing with when it comes to paramedic or pre-hospital medicine and so perfusion is the delivery of oxygen and nutrients and removal of waste from cells organs and tissues by the circulatory system so hypoperfusion occurs when the level of tissue perfusion decreases below the below normal okay okay so when the body senses tissue hypoperfusion it will set compensatory mechanisms into motion and sometimes this is uh sufficient to stabilize the patient other times it overwhelms that normal compensatory mechanism and the patient's condition deteriorates when the patient's condition deteriorates it's considered dead compensate decompensated shock and when the body's able to compensate it is called compensated shock easy enough right okay so we're going to talk a little bit about the body's response to hypoperfusion next the body releases catecholamines and those catecholamines are epi and norepi and that will produce vasoconstriction so the norepi and the epi will produce vasoconstriction the a-r-a-a-s is activated in an antidiuretic hormone is released from the pituitary gland this action triggers salt and water retention as well as peripheral vasoconstriction and what that does is it's trying to increase blood pressure and cardiac output at that time fluid will shift from the interstitial tissues into the vascular compartment the overall response is to increase the preload stroke volume and heart rate so that the blood volume is adequate the result is often an increase in cardiac output and myocardial oxygen demand persistence results in a continued increase in myocardial oxygen demand okay and so the compensatory mechanisms can no longer keep up with the demand and myocardial function will worsen tissue perfusion will decrease causing impaired cell cellular metabolism and fluid may leak from the blood vessels causing system systemic and pulmonary edema okay so other signs may be dipsnia or a dusky skin you could have low blood pressure or impairmentation",
        "Shock": "so the next thing we're going to talk about is shock when it comes to paramedic of we just talked about hypoperfusion you have to talk about shock next uh they are very interrelated so shock is an abnormal state associated with inadequate oxygen and nutrient delivery to metabolic apparatus of the cell this will result in in paracel metabolism and inadequate perfusion of vital organs remember if the cell isn't getting oxygen or the body's not getting oxygen the cells are going to revert to this anaerobic metabolism and what's going to happen is it's going to cause an increase in lactic acid production and metabolic acidosis decrease oxygen for the hemoglobin decrease atp production and changes in electrolytes cellular edema and release of enzymes glucose impairment leads to elevated blood glucose levels due to re release of catecholamines and cortisol okay and um when it when you are talking about shock it can occur due to the inadequacy of a central circulation or of a peripheral circulation okay and so this occurs basically when you have central shock it's um consists of cardiogenic shock and obstructive shock when you have peripheral shock it includes hypovolemic shock and distributive shock now we're going to break those down in more detail next and we're going to start with the central shock and when you think of central shock i",
        "Central Shock": "always think of the the harder the lungs in the central area of the body and so cardiogenic shock is the first one we're going to talk about and this occurs when the heart cannot circulate enough blood to maintain adequate peripheral oxygen delivery so most common cause is a heart attack and mi so mitocardial infarct is the most common cause of cardiogenic shock obstructive shock occurs when blood flow becomes blocked in the heart or great vessels so remember both types of central shock cardiogenic and obstructive are obstructive think about there's some type of obstruction causing the inadequate blood flow so what could cause obstructions in um in the central area so we have pericardial tamponade and remember pericardial tamponade is basically when there's fluid in that pericardial sac surrounding the heart so the heart can't fill or pump because there's that pressure on that pericardial sac also another form of obstructive shock is the aortic distent or aortic dissection so of course uh loss of blood flow because the aorta is dissecting you have left atrial tumor which could obstruct flow between the atrium and ventricle in it so there's some type of tumor in that area you also have obstruction of either superior inferior vena cava that's going to decrease that cardiac output of course and a large pulmonary emboli or a tension pneumo it may prevent adequate blood flow to the lungs okay so that's that obstructive shock which is the central type of shock and then you talk about peripheral so",
        "Peripheral Shock": "that's the second one so central or peripheral peripheral i always think of the peripheral extremities or the outlying areas so um when it comes to peripheral shock you could have hypovolemic shock okay so hypovolemic shock it's um when the circulating blood volume is unable to deliver adequate oxygen and nutrients to the body and there's two types of the of this hypovolemic shock okay and we're going to talk about those next okay so the two types are exogenous or endogenous and it depends on where the fluid loss is occurring external bleeding is the most common type of exogenous hypovolemic shock an endogenous shock occurs when the fluid loss is contained within the body that was hypoblaming shock and now we're",
        "Distributive Shock": "going to talk about the second type of peripheral shock and it's distributive shock and so distributive shock occurs when there is a widespread dilation of the vessels and so when you have circulating blood volume pulling in an expanded vascular bed the tissue perfusion decreases okay you know let's go back to this slide and the most three common types we're going to talk about of the distributive shock are anaphylactic shock and that's anaphylaxis and basically histamine and other vasodilatory proteins are released upon exposure to an um an allergen accompanied by wheezing in near dicario this results in widespread vasodilation it causes fluid to leak out of the blood vessels and into the interstitial spaces the second type of distributive shock which is peripheral shock is septic shock and this is a widespread um basically results in a widespread uh from a widespread infection if normal immune mechanisms become overwhelmed the body produces a multitude of substances that cause vasodilation this decreases cardiac output if untreated it will result in multi-organ dysfunction syndrome and death then the third type of um distributive shock is going to be also peripheral shock so um that's neurogenic shock and it usually results months from some type of spinal cord injury and the loss of normal sympathetic nervous system tone and vasodilation is lost and so you just see a widespread dilation of that vessels",
        "Management": "so now we're going to talk about management now that we know what the uh hypo perfusion is and shock now we're going to talk about management of it so most types of shock are characterized by reduced cardiac output cardiac insufficiency and a rapid heartbeat okay and so determining the presence or absence of shock requires the evaluation of the presence and volume of the peripheral pulses in absence of an organ perfusion and function so the strength of the peripheral pulses is related to both stroke volume in the heart and the pulse pressures normal skin perfusion results in being pink warm and dry right and so shock it will result in a slow delayed or prolonged capillary refill capillary refill to test briefly squeeze the toenail or fingernail and look for the return of color normal refill time is less than two seconds right but modeling polar peripheral essential cyanosis and delay cap refill may signal the presence of shock accuracy of cap refill is measured measurement decreases after the age of six however so not as useful in adult population because of the redu reduction in peripheral circulation but when we talk about management of shock measuring in tidal carbon dioxide or etco2 may also be useful you can interpret the effectiveness of perfusion using end tidal co2 decreasing levels of end tidal co2 are an early indicator of shock and low levels of etco2 combined with other signs and symptoms are omnious clinical findings",
        "Multiple Organ Dysfunction Syndrome": "the next thing we're going to talk about is multiple organ dysfunction syndrome or mods mods is a progressive condition that occurs in some critically ill patients it's characterized by concurrent failure of two or more organs or organ systems that are initially unharmed so you have types of mods so you have a primary mods or you have a secondary mod so primary mods results uh direct results of an insult or secondary mods it's a slower more progressive organ dysfunction okay and when you talk about",
        "Immune System": "pathophysiology you have to talk about the body's defense mechanisms and these are the self-defense mechanisms so the immune system includes all structures and processes associated with the body's defense against foreign substances and disease-causing agents now you have three lines of defense you have the um anatomic barriers you have the immune responses and then you have the inflammatory responses when you talk about the anatomic barriers basically there are several that decrease the chances of the body being invaded by forward substances and these are the skin you have the hairs in the upper respiratory tract in the lining of the lower respiratory tract and then you have acid in the stomach",
        "Immune Response": "when it comes to the immune response now this is the body's defense reaction to any substance that is recognized as foreign it's directed towards invading microbes which are bacteria viruses also triggered by foreign bodies and even abnormal growths in cells okay so cellular interactions in the",
        "Cellular Interactions": "immune system so it depends on the particular challenge but the basic pattern is the same bacteria will enter the body and if they are not encapsulated macrophages begin to ingest them okay so if they are encapsulated though antibiotic antibodies coat the capsule so they can be ingested by phagocytes components of the cell wall activate the complement system okay so basically already existing antibodies will assist by acting as neutralizing the bacterial toxin memory b cells attract to the infected sites will be activated if they encounter an antigen they recognize if infection is new to the body b cells will then be activated okay so on this slide you're going to see the immune response system cells you could take a look at that that's on table 9-5 in your book",
        "Immune Responses": "okay so when you comes to immune responses you have two different types you have a natural or native and and then you have an acquired immunity and they both protect the body from infectious agents and form substances so the natural or native immunity that uh that is non-specific cellular um or a humeral response that operates as a first line of defense against the pathogens it's associated with the initial inflammatory response and then you have an acquired or adaptive immunity that's a high specific method in which the cells respond to an immune stimulant with this acquired immunity now that is passively acquired in its performed antibodies and not usually from mother to infant that acquired immunity it comes to this immune response it's really important the paramedics understand this understand that you're gonna have this primary or initial immune response and that takes place during the first exposure to an antigen an antigen is otherwise known as some type of foreign substance that the body notices or or thinks then you have a secondary immune response and that occurs to on repeat exposure to that foreign substance okay so let's break this down a little bit further and the beginning or the induction phase of an immune response occurs when immune system recognizes an antigen so an antigen may be immunologic or immunogenic which is not it will have a some type of response or a non-immunogenic which does not elicit a response you have antibodies and that binds a specific antigen so that the complex can attach itself to a specialized immune cell and destroy the complex or induce a response so you can see it in this um slide right here you can see that the antigen the antibody are going to combine to form that antigen antibody complex all right so an immunogen is an antigen capable of generating an immune response against itself a haptin is a substance that normally does not stimulate an immune response but that can be combined with an antigen at a later time to initiate a specific antibody response on its own okay so we're going to talk about the humoral immunity and b cell lymphocytes produce antibodies or immunoglobulins that react with a specific antigen when it comes to the humoral immune response okay so b lymphocytes are born in the bone marrow and basically in stem cells okay and so what happens for b cells to produce antibodies they must be activated and the most common way that this occurs is via helper t cells microphanges engulf the antigen via phagocytosis and it pushes discarded particles into the cell surface where they interact with b cells and a helper t cell antigen binds with the b cell and the helper t cell activating both helper t cells secrete a lymphos lymphocyme which stimulates b cell to produce a clone clone has two identical cells that have two different functions you have the plasma cells which make antibodies and then you have the memory cells and the they remember the encounter with that antigen okay so this is a really good slide of what we just talked about you could see the beginning you could see that microphage phage engulfing the antigen with phagocytosis and then you see discarded materials being pushed and they interact with b cells in that helper t cell okay then you see um those helper t cells secreting that uh lymphocyme which stimulates the b cell to produce the clone just as i said right and then you see that memory cell in the cell mediated immunity the activation often occurs via those helper t cells which we talked about earlier and and then that clone that antigen binds to the b cell and helper t cell and then just as we talked about it produces that clone all right so we're going to talk about immunoglobulins and they are antibodies secreted by the b cells they consist of crystallized fragments um and two antigen binding of fragment regions so they bind only to a specific antigen and you could see that also in the photo right there and basically the basic antibody molecule has four chains linked into a y shaped and each side of that identical is identical with one light chain attached to a heavy chain okay so there are three main categories of antigens and antibodies there's the isotopic antigen marker and it occurs in all members of a subclass of an immunoglobulin class then you have the allotypic and that antigen marker is found on some members of a subclass okay and then you have the idiotic and that is a determinant is unique structure created on the light and heavy chain of the immunoglobulin molecule all right so we're going to talk about antibodies they make antigens more visible to the immune system in three ways all right and so they make them more visible by um opsinization and this is an antibody coats an antigen to facilitate its recognition by the immune cells and antibodies cause antigens to clump for easier phagocytosis and then antibodies bind to and inactivate some toxins produced by bacteria so micro fanges can ingest them okay and then you could see the general classes of those immunoglobulins on the chart on 9-6 okay so next we're going to talk about cell mediated immune responses so cell mediated immunity is characterized by the formation of a population of lymphocytes that can attack and destroy foreign material they're the main defense against viruses fungi parasites and some bacteria okay so the mechanisms by which the body recognizes transplanted organs and eliminates abnormal cells that sometimes arise all right so the t-cell lymphocytes recognize antigens and contribute to the immune response in two ways they secrete uh cytokines that attract other cells and become cytotoxic and kill infected or abnormal cells so there are five subcategories of t cells and we're going to talk about those next so you have the killer t cells and they destroy antigens you have helper t cells they activate immune cells including b cells and other t cells you have suppressor t cells and those suppress the activity of other lymphocytes so they can or they do not destroy normal tissue you have memory tissue cells remember the reaction for the next time it is needed is what those memory t cells do and then you have this lymphocene producing cells they work to damage or destroy cells infected with a virus okay so an inflammatory response is the",
        "Inflammatory Responses": "response of a body of the body to irritation or injury it's characterized by pain swelling redness and heat and the most common causes are injury and illness infection and injury right so you have the acute inflammation and this involves both vascular and cellular components it's um basically it causes blood vessels to expand vessel wall becomes thinner and fluid leaks into that interstitial space and this causes edema and when enough pressure has been released vessel walls contracts and outflow slows this leads to stasis of blood in those capillaries with the acute inflammation you have a variety of cells participating you have white blood cells which are the leukocytes platelets mast cells plasma cells which are the b lymphocytes and then specific cell types include neutrophils monocytes lymphocytes basal basal fills and activated platelets so chemical mediators account for the vascular and cellular events that occur this includes histamine and then some type of acid derivatives and cytokines mast cells degranulate and release a variety of substance the major stimuli for d granulation are physical injury chemical agents and immunological substances they release a vasoactive and and mines and histamine and serotonin it increases vascular permeability uh it causes vasodilation and can cause bronchial constriction nausea and vomiting they synthesize leukotrienes which is a slow reacting substance of anaphylaxis okay and then they simply synthesize pros dana glanins next part or next inflammatory response we're going to talk about is the plasma protein system and this is plasma derived mediators that modi modulate the inflammation inflammatory response it's a complement system basically and it's a group of plasma proteins that attract white blood cells to site sites of inflammation activate white blood cells and directly destroy cells so the components are basically you have the c3 it's a central compound it's produced by one of the two pathways a classic pathway it starts when the antigen and antibody complex combines to the um complement all right and so they activate um indep is dependent on the process of these antibodies okay and then you have the second one is an alternate pathway it's triggered by a bacterial toxin and does not need antibodies to be activated okay so the next inflammatory response we're going to talk about is the plasma protein systems and that is the coagulation system and it performs a vital role in the formation of blood clots and facilitates repairs of that vascular tree so inflammation triggers a series of reactions that encourage fibrin formation and fibrin is a protein that basically bonds to form fibrous component of the blood clot and the um what happens is there's a cascade it activates to dissolve the fibrin and create fibrin split products all right and then the pros of a protein system we're going to talk about is going to be the uh kinin system and this leads to the formation of a vaso active protein bradykinin from a calicrine and so the uh calicrine enzyme normally found in the blood plasma urine and body tissue is in the inactive state and basically um it activates and it increases vascular permeability dilates blood vessels contracts smooth muscle and causes pain when injected into the skin and you have the hagam man factor and that spurs the kidney system into action so this triggers intrinsic clotting cascade which occurs when blood is exposed to collagen and other substances so the cellular components of inflammation so the goal is for inflammatory cells specifically these neutrophils to arrive at the sites within tissues where they are needed the there's two major stages and so you have the intravascular phase and that's when leukocytes move to the sides of the blood vessels and attach to the specific cells and then you have extravascular phase and that's when leukocytes travel to the site of the inflammation and kill the organisms and what happens you have this cellular event response okay you have the marginalization and that's a loss of fluid cause causes blood to increase its viscosity so blood flow slows and produces stasis leukocytes move towards the sides of the blood vessels and bind to epithelial endothelial cells the activation the mediators trigger the appearance of basically um integrins on the surface of these epithelial cells and you have adhesion so the they actually attach to those uh endothelial cells you have um a permanent permeation through the vessel wall moving to that interestial space okay and then these pm pmns move towards the site of the inflammation in response to that uh chemotactic inflammation process and it basically on this slide it's going to show you that cut cellular component in in that shifting of the moving to the vessels moving out of the vessels moving to the sites that's showing you that process next we're going to talk about the cytokines and they they're products of cells that affect the function of other cells and so when you talk about this you have those interleukins they attract white blood cells to the sites of the injury and then you have the interferon and that is proteins produced by cells invaded by viruses so they are released into the bloodstream or intracellular fluid to induce healthy cells to manufacture an enzyme that counters the infection and so those are the two type of cytokines okay so lympha kind stimulates leukocytes and a microphages activating factor stimulates microphages to engulf and destroy foreign substances there's a migration factor that keeps white blood cells at the site of the infection or injury until they can perform their designated task okay so injury resolution and repair when it comes to that normal wound healing involves four steps you have a repair of the damaged tissue you have rep removal of the inflammatory debris restoration of the tissue to the normal state and then regeneration of cells when it comes to healing after an injury or loss depends on the type of cells that make up the affected organ okay so you have um the label cells and they divide continuously so organs derived from these cells heal completely then you have stable cells and they are replaced by regeneration from remaining cells and then you have permanent cells and they cannot be replaced scar tissue is laid down instead so wounds can heal by primary intention and this occurs in clean wounds with opposed margins and then you have secondary intention and this occurs in large gaping or infected wounds it's more pronounced and prolonged inflammatory response so you have factors that lead to dysfunctional wound healing and it may be local or systemic and so when you have these you so systemic factors include poor nutritional intake or hemologic abnormalities so diabetes and aids affects the cells of the immune system increasing the chance for infections and corticosteroids suppress the initial inflammatory response required for the proper formation of scar tissue and increase the risk of wound infection wound separation slows down and the healing process as healing needs to start over to some extent all right so chronic inflamma inflammatory responses and um these causes include a successful acute inflammatory response to a foreign body or a persistent infection or persistence or presence of an antigen it's associated with an infiltrate or pus containing monocytes and lymphocytes it's usually involved tissue destruction and repair events are similar to those in acute inflammation process but also include the growth of new blood vessels okay so we're going to talk about variances in the immunity and inflammation next and so hypersensitivity is any response of the body to any substance to which a patient has increased sensitivity you could have an allergy and that's hypersensitivity reaction to the presence of an antigen or otherwise known as an allergen you could have an autoimmunity and that's produced or production of antibodies or t cells that work against the tissue of its own body and then you have osmond immunity iso immunity and that's formation of t cells and or antigens or antibodies directed against the antigen on another person's cells and that's typically um after organ transplant or some type of blood transfusion and so let's talk about type one so type one is an immediate hypersensitive or hypersensitivity reaction and it's acute reaction to that stimulus okay and so basically the reaction may be immediate um and uh it's uh involves interaction between the stimulus and a performed antibody of the ige type severity of the symptoms depend on the extent of the mediator response and it varies from life-threatening to maybe to a mild basically milder reaction and then so this is type one and uh treatment in the field includes administrations of epi via epipen auto injector or some type of subcutaneous injection of ep you have type 2 and basically this is the um cytotoxic hypersensitivity this involves a combination of that ig or igm antibodies with antigens on that cell membrane remember we talked about that earlier cells are destroyed by this fixation or by another antibody so that healthy cells may be destroyed it occurs within a few hours of the exposure examples include blood transfusions so when you think about the blood transfusion or that reaction to it this is a type 2 type 3 you have tissue injury caused by immune complexes so it occurs within a few hours of the exposure reactions may be systemic or localized systemic form is results from a large single exposure to an antigen and then a localized is consistent of a basically an area of vascular inflammation and then next moving on the last but not least we have type 4 that's a delayed or cell mediated hypersensitivity it's primarily mediated by some soluble molecules that are released by specifically activating t cells you have also two subtypes you have a delayed and then you have that cell mediated type moving on we're going to move into the targets of hypersensitivity reactions so you have allergic reactions and this is caused by or target is an antigen or an allergen you have an autoimmune reaction and this is targets is the target is a person's own tissue and so when you talk about autoimmune reactions specifically we could break it down into even further you could talk about graves disease and that's an autoimmune disease that's caused by thyroid stimulating or thyroid growth immunoglobulins and then you have type 1 diabetes mellitus that's um some agent causes the body to produce antibodies or auto antibodies against beta cells okay so that's type 1 diabetes you have rheumatoid arthritis and that's a chronic systemic disease it's one of the most common forms of forms and it's characterized by inflammation of the synovium and the synovium is a connective tissue membrane lining the joints okay so that's rheumatoid arthritis that's a chronic most common um type of an autoimmune disease next one we're going to talk about an autoimmune reaction is the myosthenia gravis and that's an acquired autoimmune disease and that's characterized by attack on the nervous muscle junction the next one is neutropenia and that's a decrease in the circulation of neutrophils and it decreases the body's ability to fight reactions okay so itp is a blood disorder in which the patient forms antibodies two blood platelets that cause their destruction so bleeding is the main symptom treatment is based on the severity of symptoms and the platelet count then you have systemic lupus and that's the body's own immune system is directed against the body's own tissues you know deficiency is an abnormal condition in which some part of the body body's immune system is inadequate you have congenital immunodeficiencies and they those are defects which involve the lymph node stem cells and affects both t and b um cells okay so then you have the x-linked um and that affects male infants and it's caused by a defect in uh the differentiation of the pre-b cells and the b cells okay so that affects those the male vince and then you have isolated deficiency of iga and that results from a block in the terminal differentiation of the b lymphocytes okay so you could have acquired immunodeficiencies when you talk about acquired emission immunodeficiencies the contributors to this condition include new nutritional deficiency stress trauma hypoperfusion or shock you have mediator production damage to vital organs or decreased nutrition occurring during trauma states you also have the um immunodeficiency basically it's the most frequently caused by drugs so that's treatment induced and it's often a therapeutic benefit however it may lead to other types of diseases so physicians are usually cautious about prescribing this therapy for long periods of time for a long time physical or mental stress has been shown to decrease white blood cell and glucose leukocyte function so and then aids is caused by an rna retrovirus hiv which binds to helper t cells infecting and killing them replacement therapy for some types is how you um you would treatment of immunodeficiencies and so you could they have intravenous gob gamma globulin and that's used in therapy of a number of immunologic disorders of the nervous system also bone marrow transplants and this is used in persons with acquired causes of the immunity deficiencies and then transfusions are also used as treatment of immunodeficiencies there are factors that cause diseases and these factors are genetic environmental age related and sex associated factors can cause or contribute to diseases genetic factors are present at birth and are passed through a person's genes to future generations environmental factors include microorganisms immunologic and toxic exposures personal habits and life styles exposures to chemicals and physical environment and psychosocial and environment so uh the autoatomic causes include um the male rotation of the colon degenerated diseases of the spine or a aortic stenosis and immunological reaction may result in disease also have an agent that triggers an abnormal response against melon and this is the it leads to the development of multiple sclerosis so you have uncontrollable and controllable factors that cause diseases uncontrollables of course are factors that include genetics and race then you have controllable factors which are smoking drinking alcohol inadequate nutrition lack of physical activity and stress now you have age-related risks and risk of a particular disease often depends on the patient's age so newborns are at risk because immune systems are not fully developed and teenagers are at risk because of trauma use of drugs and alcohol older adults older adults greater risk for cancer heart disease stroke and alzheimer's disease okay then you have sex associated factors and uh and these include um prevalence more in one sex than the other and so some diseases are more prevalent in men than in women and vice versa so more prevalent in men is lung cancer gout and parkinson's disease more prema prevalent in women are osteoporosis rheumatoid arthritis and breast cancer and presentation of the disease can differ from men to women as well when you start to analyze the disease risk there are conversational risk factors and those are factors that can directly cause a disease to develop and then there's non-causational risk factors and those are factors that are associated with the risk for the disease but not a direct cause all studies should consider the incidence prevalence morbidity and mortality of the disease and incidence is the number of new cases in that population prevalence is the number of new cases in a particular population within a particular period morbidity is the presence of disease or incidence or prevalence of the disease and then mortality is the number of deaths from the disease in a given population expressed as a proportion okay you could look at the slide and you could see the risk factors um often interact and this is a showing common respiratory diseases it's on table 9-11 chapter 9. all right and then you have common familial diseases and so when it comes to common common familial diseases and associated risk factors you have a genetic risk and that's one that is passed through generations by inheritance inheritance of a gene you have a familial tendency and that's cluster of diseases in a family group despite lack of evidence for heritable gene associated abnormalities then you have an autosymmonial dependent or dominant that's a person needs to inherit only one copy of a particular form of the gene to show that trait and then you have an immunologic disorder and it's caused by either hyperactivity or hypoactivity of an immune system okay most that exhibit familial tendencies involve an overactive immune system when it comes to allergies they're acquired following an initial exposure then you have asthma it's a chronic inflammation condition of course and then this is just showing common familial diseases uh a chart and the reaction of that and then we talk about cancer this includes a large number of malignant growths uh prognosis often depends on the extent of the spread so the spread is metastasis metastasis and the effectiveness of the treatment so lung cancer is the leading cause of death due to cancer in the united states major risk factors is cigarette smoking eight alterations in genetic material lung cancer that may suggest a genetic tendency other predisposing factors include exposure to asbestos coal products and other industrial chemical products symptoms include cough difficulty breathing blood tinge sputum sputum and repeated infections and then you have breast cancer the most common type of cancer in women women who first degree relatives have breast cancer are two point times 2.1 times more likely to develop the disease risk factors are they vary with age at which the affected relative was diagnosed five to ten percent of patients have a pattern of autosomal de dominant inheritance and then a colorectal cancer it's the third most common type of cancer in both males and females relatives of patients with colorectal cancer are more likely to have the disease themselves symptoms may be minimal such as small amounts of blood in the stool and treatment involves surgery and sometimes chemotherapy endocrine disorders so diabetes mellitus is a chronic disorder of the metabolism associated with either partial insulin secretion or total lack of insulin secretion by the pancreas symptoms includes excessive thirst and urination weight abnormalities and the presence of excessive glucose in the urine and blood ketoacidosis comes with type 1 diabetes and that is insulin dependent diabetes mellitus non-ketoacidosis prone that's type 2 diabetes that's non-insulin dependent diabetes hemophilia when you talk about hemophilia hemophilia and anemia that's characterized by increased destruction of red blood cells there's a number of causes rh factor blood transfusion reaction uh disorder is of the immune system and then you have the hemophilia um which is the basically there's an inherited disorder which is characterized by excessive bleeding that's sex link condition and it occurs only in males passed from the mother to the sun hemoglobin that's when the body absorbs more iron than needed excess iron is stored in various organs it can lead to diabetes heart disease liver disease impotence and a bronze skin color and this shows that disease on the slide so dietary iron it shows confined with the protein and you could go through that the slide and then common passed down familial diseases you could have cardiovascular disorders and which range from long qt syndrome it's a cardiac condition system abnormality resulting in a prolonged prolongation of that qt interval on the um on the ecg and so it's considered a life threat if you have an extra exercise induced syncope or syncope associated with chest pain or history of syncope or syncope associated with um startle okay so cardi and the next cardiovascular disorder we're going to talk about is cardiomyopathy and that's a disease of the myocardium it leads to heart failure acute mis and death mitral valve prolapse that's a mitral valve leaflet balloons into the left atrium during systole you could have cardio or coronary heart disease it's called by impaired circulation of the heart and then high blood pressure or hypertension also some types of renal diseases are are passed down from generation to generation including gout that's an abnormal accumulation of uric acid due to a defect in the metabolism what happens it is accumulates in the blood and joints it causes pain and swelling more common among men than women and usually has a genetic basis if left untreated it causes destructive tissue changes in the joints and kidneys and treatment includes diet and drugs also kidney stones those are small masses of uric acid or calcium salts that form in any part of the urinary system often causes severe pain nausea vomiting when the body attempts to pass them researchers have found a gene that causes the intestines to absorb too much calcium and uric acid stones often have a genetic basis gastrointestinal disorders are known to be passed down so peptic ulcer disease and basically that's erosions in the lining of the gastrointestinal tract gallstones are stone-like masses in the gallbladder obesity is an unhealthy accumulation of body fat morbid obesity of course is more than or greater than a body mass index of 40 kilograms and overweight that's a bmi of 25 to 29.9 and then a neuromuscular disorder so huntington's disease that's characterized by progressive um basically cornea and mental deterioration muscular dystrophy that's acute that's a group of hereditary diseases of the muscular system multiple sclerosis that's when the millennium melanin sheath surrounding the nerve fibers of the brain and spinal cord become damaged also alzheimer's disease that is a common of familial disease passed down and it results in atrophy loss of neurons in ventricular enlargement in the brain and then schizophrenia is a psychiatric disorder which is passed down it's a group of mental disorders distortions of reality withdrawal and disturbances of thought language perception and emotional response and bipolar disorder is a common familial disease it's characterized by episodes of mania and depression all right so when we start talking about stress and disease stress is the medical term for a wide range of strong external stimulus that causes a physiologic response okay so um basically the physiologic stress um is a change that makes it necessary for cells of the body to adapt so there's three concepts of that and it includes the stressor the effects and the body's response to that usually response to stress is appropriate and beneficial however unchecked stress response can result in outcomes which are detrimental including chemical dependency heart attacks stroke depression headaches and abdominal pains okay so you have a general adaptation syndrome and you have different stages it's characterized by three stages of reaction to stressors when you have the first stage that's the alarm and a body reacts to by releasing catecholamines such as uh epinephrine which is adrenaline and norepi which is nora adrenaline and dopamine so adrenaline of course we know this acts as a neurotransmitter and cns and as a hormone in the blood okay and so um basically norepi is a primarily a neurotransmitter of the peripheral sympathetic nervous system and so effects are going to include increased respiratory rate decreased blood flow to the skin smooth muscle constriction and various effects on the liver that increase the body's ability to lose glucose this is basically that fight or flight response and it can either prepare the body to deal with stress or it could weaken the immune systems and then you have type 2 or stage 2 that's the body's way of adapting to stressors it stimulates the adrenal gland to secrete two types of corticosteroid hormones that increase blood glucose levels and maintain blood pressure all right so the hypothymus stimulates the anterior pituitary gland to release acth and that targets adrenal cortex to release cortisol what it does is it stimulates cells to increase energy production and increases serum glucose levels and impairs the use of glucose by peripheral tissues when it comes to and just what we just said is is on this slide so um that act is stimulated other hormones are released and um so this reduces inflammation when it served its purpose it increases red blood cell production and affects electrolyte levels it decreases the size of lymphatic tissue which plays a role in immunity and other hormones related to stress okay and then the third stage we have is exhaustion so exhaustion adrenal glands become depleted diminishing the level of blood glucose and that results in decreased stress tolerance progress or progressive mental and physical exhaustion illness and basically collapse so the body's immune system is compromised and reducing the ability to resist diseases all right so now we're going to talk about some effects of chronic stress and so this is um basically uh an hpa access and it's a major part of the endocrine system that controls reactions to stress and so what happens is it triggers a set of interactions among the glands hormones and parts of the midbrain that mediate the general adaption syndrome continued stress leads to loss of these normal control mechanisms continued production of cortisol exhausts the stress mechanisms and leads to fatigue and depression consistently high levels of that lead to suppression of the immune system and so stress and depression have a negative effect on the immune system it causes the body to lose its ability to fight disease it encourages the body to release fat and cholesterol into the bloodstream eventually causing heart attacks and strokes it also related conditions include depression headaches insomnia ulcers diuresis acne diabetes mellitus rheumatoid arthritis and asthma coping mechanisms play a role in the um response to stress so healthy persons may manage stress and very little impact on the immune system patients with ineffective coping mechanisms will have detrimental effects on the um immune systems effects are worse on a person with an already compromised immune system okay so this concludes the pathophysiology chapter 9 lecture i hope you've enjoyed it and go ahead and subscribe to the channel if you did we're going to be releasing all the chapters in the the paramedic textbook okay and have a good night"
    },
    {
        "Introduction to Anatomy and Physiology": "hello and welcome to chapter eight of anatomy and physiology lecture this is going to be part one we're going to have a two-part series after you complete part one of this lecture and the related coursework you will be able to describe the anatomy and body planes topographical anatomy directional terms and the atomic position part two you're going to be able to identify some basic anatomic structures and related functions and describe each body system we're going to be able to discuss possible consequences of illness and injury of these structures and systems on proper functioning of the body so let's get started",
        "Importance of Anatomy and Physiology": "knowledge of anatomy and physiology is necessary for every patient encounter anatomy is a study of the structure and makeup of the organism gross anatomy studies organs and their locations in the body and microscopic anatomy studies the tissues and cellular components that cannot be seen by the naked eye physiology is the study of the process of the functions of the body",
        "Characteristics of Life": "so let's talk about the characteristics of life to understand the design and function of the body consider the characteristics shared by all living organisms there's absorption and that's the ability to absorb materials through various membranes such as absorption of material through the digestive tract circulation and that's the ability to move substances in the body by way of body fluids there's digestion that's the ability to convert food sources into smaller compounds excretion is the ability to excrete waste materials and growth is the ability to increase in size there's movement that's the ability to change locations or positions or move internal structures reproduction is to create cells such as cellular reproduction respiration is the ability to use food sources and responsiveness that's the ability to respond to internal and external stimuli",
        "Organizational Structure of the Body": "to achieve the functions listed previously the body is organized to ensure the organism works as a whole organism comes from organized plas-ism which indicates that organization is crucial in the body the levels of organization process from the simplest which is chemical to the most complex which is the body as a whole there are six basic units of organization so chemical cellular tissue organ organ system and organism",
        "Atoms, Molecules, and Chemical Bonds": "so let's talk about chemical changes next okay so changes within cells influence body functions and the status of the structures of the body chemicals in the body include water proteins carbohydrates lipids nucleic acids and salts as well as foods drink and medicines so when you talk about matter elements and atoms mass is a physical property that determines the weight of the object based on the gravitational pull of earth matter includes liquid gases solids both inside and outside of the body and then you have the elements that's the simplest form of matter it makes up all living and non-moving matter cannot be broken down into two or more different substances",
        "Atomic Structure and Chemical Bonds": "so atoms are the smallest units of an element and they vary in size weight and how they combine and interact with other atoms atoms make up the characteristics of of living and non-living things and atoms combine with other atoms not similar to them to form chemical bonds so atoms are composed of particles that include protons protons remember they're positive electrons are negative and neutrons well they're neutral they're uncharged electrons orbits the nucleus of the atom at a high speed forming an electron cloud atoms normally contain an equal number of protons and electrons atoms refer the atomic number refers to the number of protons in an atom for example hydrogen has one proton the atomic number of one magnesium with 12 protons the atomic number is 12. the atomic weight of the electron tron's atom is the number of protons and neutrons in its nucleus so for example oxygen has eight protons and eight neutrons so the atomic weight is going to be 16. isotopes are atoms with nuclei containing the same number of protons but different number of neutrons so let's talk about chemical bonds next bonding with other atoms so atoms can bond with other atoms by using chemical bonds that result from interactions between their electrons they could gain lose or share electrons first chemical bond we're going to talk about is the ionic bonds and those are formed between ions and ions with a positive charge are cations ions with a negative charge charge are anions and then there's covalent bonds covalent bonds form when atoms are bonded to form molecules by sharing electrons polar molecules have equal number of protons and electrons but one end of the molecule is slightly negative while the other end is slightly positive a peptide bond is another type of covalent bond and then we have hydrogen bonds they form between height a hydrogen atom and a negatively charged atoms such as oxygen nitrogen or fluorine important protein in nucleic acid structures and form between polar regions of different parts of a single large molecule so formulas molecular formulas represent the number of types of atoms in the molecule so water's formula is h2o signifying that the two atoms of hydrogen and then one atom of oxygen when you talk about compounds it's a substance that can be broken down into two or more elements contained within it so examples include water tables sugar baking soda alcohol as used in beverages natural gas and most medicinal drugs a molecule of a compound has specific types of n amounts of atoms and then there's minerals it's a naturally occurring inorganic element it's used in the chemical reactions that occur in the body necessary to sustain cell function and obtain for humans from plant foods or from animals that they've eaten and then the animals have eaten the plants all right classified as microminimal minerals also called macronutrients or trace minerals when the daily dietary requirement is 100 milligrams or more so example include calcium magnesium or phosphorus micro minerals so you had macro first now you have micro minerals is when the body needs less than 100 milligrams daily and examples of those are copper iodine or iron maybe zinc organic compounds contain the element carbon organic molecules are made up of long chains of carbon atoms linked by covalent bonds carbon atoms usually form additional cavella bonds with hydrogen or oxygen atoms and less less commonly form covalent bonds with nitrogen phosphorus sulfur or other elements biochemical compounds are organic compounds that occur in living organisms and then there's carbohydrates these are the sugars and starches they're compounds made up of carbon hydrogen and oxygen energy mostly used to power cellular process there's types of carbohydrates there's the monosaccharides which are simple sugars or the disaccharides those are double sugars or the poly those are complex sugars simple sugars such as glucose fructose and galactose and then enzymes they're in the liver the largest internal organ in the body of course and they convert fructose and galactose into glucose then you have ribose and dexa ribose these are simple sugars used in the manufacture of ribonucleic acid that's rna and dna the so-called blueprint of the cell disaccharides are they must be broken down into monosaccharides before they can be used in the cells polysaccharides are long chains of monosaccharides linked together examples include plant starch or animal starts or and cellulose",
        "Proteins": "proteins that's most abundant of the body's organic compounds they contain carbon oxygen hydrogen and nitrogen they include enzyme plasma proteins muscle components and hormones in antibodies hormones are substances formed in tiny amounts by one specialized organ or group of cells and then carried to another organ or group of cells in the same organism to perform regulatory functions antibodies those are proteins that detect and destroy foreign substances you have the structural proteins such as collagen and keratin proteins of cell membranes those are the cell walls and then you have 20 22 different amino acids they make up proteins that exist in humans and most other living organisms peptides are protein molecules containing or consisting of amino acids held together by peptide bonds most synthesized by the the adult's body is essential amino acids and they're required for proper growth and tissue repair and then non-essential amino acids are produced by the liver and are therefore not dietary requirements",
        "Lipids": "when you talk about lipids they're composed of carbon hydrogen and oxygen lipids are not soluble in water and so they may dissolve in other lipids oils or either chloroform or alcohol the most common lipids in the body are triglycerides phospholipids and steroids and steroids contain cholesterol triglycerides are the most common lipids and they're made up of glycerol and fatty acids then you have fats you have saturated and unsaturated and monosaturated so saturated is mostly found in meats eggs milk and animal fat unsaturated exists in nuts and seeds and then the monounsaturated are the healthiest type they're found in olive peanut and canola oils so the functions of lipids ellipse lipids have many functions but mostly they supply energy to the body fatty acids essential fatty acids cannot be synthesized by the liver free fatty acids are used by the liver to synthesize triglycerides phospholipids and lipoproteins cholesterol is synthesized and released into the bloodstream by the liver removed from the bloodstream to be excreted via bile or to produce bile salts triglycerides are stored stored in adipose tissue and of course that's the fat tissue they may be hydrolyzed so that's broken down into free fatty acids and glycerol when blood lipid concentration drops such as during fasting",
        "Vitamins": "vitamins so other organic compounds that are required for normal metabolism they classified by their solubility fat soluble vitamins are a d e and k water soluble are the b vitamin group and the vitamin c then you have bile salts and in the small intestines they promote absorption of fat soluble vitamins bile salts accumulate in various tissues and their intake must be controlled",
        "Nucleic Acids": "next we're going to talk about nucleic acids so there's their large organic molecules or macromolecules so big molecules that carry genetic information or form structures within the cells so there's two classes of nucle nucleic acids there's dna and rna dna in your cells determines your inherited characteristics and encodes the information needed to build proteins rna is important in the process of manufacturing proteins by using the information provided by the dna of course the human cells they have three types of rna they have messenger transfer and ribosomal",
        "Inorganic Compounds": "when you talk about inorganic compounds they are necessary for fluid balance and for transporting materials through cell membranes organic substances in body cells include oxygen carbon dioxide compounds that are known as salt and water oxygen enters the body through the respiratory organs and it is transported into the blood salts are compounds of oppositely charged ions that are abundant in tissues and fluids",
        "Enzymes": "chemical reactions so form and break down chemical bonds altering chemical substances the important sensor enzymes enzymes are among the most important of all bodies proteins because they catalyze the reactions that sustain life enzymes in their actions so they assist in the digestion of food drug metabolism protein formation and other types of reactions they lower the amount of activation energy needed for metabolic reactions they act as a substrate which is a particular chemical affected by an enzyme they have three dimensional shapes that allow them to identify their substrates and they form an enzyme substrate complex altering of enzymes so enzymes are most often proteins that can change through exposure to heat electricity chemicals radiation or fluids that have extreme ph so denaturing is defined as changing or altering some of the substance of the enzyme okay some enzymes must combine with a non-protein component in order to be active",
        "Types of Chemical Reactions": "there are four important types of chemical reactions this is synthesis reactions decomposition reactions exchange reactions and reversible reactions first we'll talk about synthesis reactions they occur when two or more reactants bond to form a more complex product or structure synthesis requires energy decomposition reactions occur when bonds within the reactant molecule break forming simpler atoms molecules or ions exchange reactions occur when two substances are decomposed and synthesized to produce new compounds okay reversible compounds are reactions in which the products of the reaction can change back into the reactants they originally were cellular metabolism because of metabolism organisms grow maintain body functions release or store energy produce and eliminate waste and digest nutrients and destroy toxins and then there's catabolism so this is a chemical reaction that results in the breakdown of larger molecules into smaller ones that the body can use for its own needs anabolism is the process of building larger substances in the body from smaller substances",
        "Electrolytes, Acids, Bases, and the pH Scale": "electrolytes are substances that release ions in water when electrolytes dissolve in water the negative and positive ends of the molecule cause ions to separate and interact with molecules water molecules instead of each other the resulting solution contains electrically charged particles which are ions that will conduct electricity a solution is a mixture of two substances you have a solvent that's the fluid that does the dissolving and then you have the solute solute the dissolved particles contained in the solvent these solutes can be classified as electrolytes or not electrolytes so consider the following in a measurement of electrolytes the unit of the measurement is the equivalent one mili equivalent of a cation reacts completely with one melee equivalent of an amon so primarily cations in the body are sodium and potassium and calcium magnesium primary anions in the body are carbohydrates chloride and phosphorus when you talk about acid bases and the ph scale acids are electrolytes that release hydrogen ions into water bases are electrolytes that release ions that bond with hydrogen ions acidity or alkalinity of a solution is determined by the amount of free hydrogen in the solution in body fluids concentrations of hydrogen ions greatly affect chemical reactions the values of ph are measured measures of hydrogen ion concentrations so the ph scale ranges from 0 to 14. the midpoint is 7 and it's considered to be neutral measurements of less than 7 are considered acidic measurements of more than 7 are considered basic or alkaline the ph value of the human body usually ranges from about 7.35 to 7.45 acidosis is caused by blood ph lower than 7.35 alkalosis is caused by blood ph higher than 7.45 buffers are molecules or compounds that regulate changes in ph so their weak acids buffer system includes proteins phosphate ions and carbohydrates so the figure shows the ph scale and you can see that pretty clearly",
        "Cell Physiology": "okay so let's talk about cells next these are the basic functional unit of the body cells with a common job are grouped closely together and they're called tissues groups of tissues that perform inner related jobs are they form organs and cells perform the following seven general functions you have muscle cells and those are for movement nerve cells that's for conductivity um you have metabolic absorption that's the kidney in the intestines secretion that's the mucus and gland cells excretion that's all cells respiration is all cells and reproduction is most cells",
        "Structure of the Cell": "when you're looking at the cell structure you have two general classes of cells you have sex cells and somatic cells sex cells are germ cells or reproductive cells somatic cells are all other cells they're highly organized structures and they're surrounded by a cell membrane we'll go a little bit into the parts of the cell so you have the cell membrane and of course that's the it encloses the cytoplasm in the organelles you have the nuclei of the nucleus that stores the cell's genetic material and controls the activities the cytoplasm is the fluid-like material in which the organelles of the cell are suspended",
        "Cell Membrane": "the cell membrane we talked a little bit about that that gives the form to the cell it's where the cellular activity takes place it provides physical isolation between the intracellular and extracellular compartments controls the movement of the substances in and out of the cell and it can be differentially permeable or semi-permeable allowing certain elements to pass through while others not allowing to go through so you have actual channel proteins and they act as a pore through the membrane that allow passive passage of substance into the intracellular compartment you have enzyme receptors they act as sites where enzymes can bind proteins that act as receptor sites and carrier proteins they bind to substances and transport them across the cell membrane you have membrane proteins some attach to the cytoplasm of the cell and help determine its shape and others allow tissues to form you have membrane proteins and those some attach to the cytoskeleton of the cell and help determine its shape and others allow tissues to form next we're going to talk about the cytoplasm as we mentioned earlier it's a fluid-like material in which the organelles are suspended it contains membranous networks protein frameworks and the cytoskeleton and organelles perform specific function related to the cell structure growth maintenance and metabolism",
        "Organelles": "organelles have specific actions that help the cell to carry out its activities cilla and flagella are structures that extend from certain cells cilla of course are those hair like projections they move in a coordinated sweeping motion and allow fluids over the substances and then flagella are those long cilla and often exist as a single flagellum such as on a sperm cell ribosomes are either floating or freely floating freely or attached to the endoplasmic reticulum and deposit reticulum is a chain of channels and sacs that wind through the cytoplasm and connect to the nuclear membrane to the cell membrane you have the smooth and the rough so ser and the rer you have the golgi apparatus and that's uh which consists of a stack of several flattened sacs and it has three main functions basically it packages secretions packages enzymes and renews and modifies the cell membrane lysosomes are tiny sacs that perform housekeeping and um microfilaments are composed of proteins actin and myosin they're typically found in the muscle cells peroxisomes they are sacs with enzymes that speed up biochemical reactions and they're abundant in the liver and kidneys thick filaments are massive bundles of subunits composed of protein myosin you have vesicles or vacuoles and they're bubble-like structures within the cytoplasm that transport a wide variety of substances inside the cell and to the exterior part of the cell",
        "Nucleus": "the nucleus is the large structure located near the center of the cell that encases the nucleoplasm so the nucleoplasm contains the dna it's the fluid within the nucleus that suspends the following structure so the nucleolus and the chromatin when you talk about the life cycle of",
        "Life Cycle of the Cell": "the cell you have four steps the interphase cell division and the cytoplasmic division and then the differentiation so most human cells can divide 40 to 60 times before they die interphase that's when the cell obtains nutrients to grow and duplicate",
        "Cell Division and Cytoplasmic Division": "and cell division and cytoplasmic division so there's two types there's meiosis and mitosis meiosis is the cell division that occurs in production of an egg and mitosis is the division of the nucleus of the cell to increase the cell numbers in the body all cells except egg and sperm cells are divided by mitosis and their stages of mitosis are the prophase metaphase anaphase and telophase you could see those phases on the figure and it shows the mitosis and cell division cytoplasmic division begins during anaphase and continues through telophase the cell membranes constrict down the middle portion of the cell two normally newly formed nuclei are separated and half of the organelles are distributed into each new cell when it comes to the differentiation it's a process of specialization of the cell that makes each cell unique so new cells must be generated in order to form growth and tissue repair to occur stem cells can divide rapidly and repeatedly without specializing cell division in cancer so cell division and growth normally occurs at approximately the same rate as cell death cell division and growth higher than the cell death rate causes tissues to enlarge that's a tumor or neoplasm is a mass of tissues produced by abnormal cell growth and division a benign tumor remains within that capsule made of connective tissue a malignant tumor spreads into surrounding tissues in a process called invasion malignant tumors can travel to other organs or tissues and that's a metastasis to establish secondary tumors metastasis is not easily controlled cancer cells grow and multiply by taking nutrients in space from normal cells so cellular signaling to work as a cohesive unit cells must be able to communicate with other cells and within individual cells cell signaling means it's a means by which cells electrochemically communicate it's used to maintain homeostasis fight infection reproduce and perform normal functions alterations and signals can lead to cell dysfunction",
        "Cellular Respiration": "okay so let's talk about cellular respiration cellular respiration is the process that releases energy in the form of atp it requires three types of action so you have the glycolysis you have the krebs cycle and the electron transport system oxidation that's the use of glycolysis by the cell it results in carbon dioxide water and the high energy molecule atp glycolysis does not require oxygen and is occasionally referred to as anaerobic process anaerobic means not needing oxygen after the molecule the glucose molecule moves into the cell two phosphate molecules gained from breaking down two molecules of atp immediately attached to it in separate steps so this figure shows anaerobic metabolism and a anaerobic metabolism so anaerobic has no oxygen and aerobic is oxygen meeting the krebs cycle is also called the citric or citric acid cycle the key to this stage is the breakdown of glucose in the presence or absence of oxygen because the krebs cycle only occurs in the presence of oxygen it's an aerobic metabolism um the pyritic acid form during the glycolysis undergoes a complex series of steps that produces several products including three molecules of carbon dioxide and one molecule of atp electron transport system occurs on the inner crests of the mitochondria where the production of atp takes place the atp and carbon dioxide and several other products transfer their electrons which produce 34 molecules of atp the results of cellular cellular respiration at the completion of all steps of cellular respiration 38 molecules of atp are produced two molecules of glycolysis and 36 molecules of aerobic respiration okay so let's talk about aerobic versus anaerobic respiration so the presence of oxygen is crucial to the efficient oxygenation of glucose in the cells when oxygen is present the majority of the respiration that takes place place is aerobic respirations can also occur in the absence of oxygen remember we said that that's anaerobic respiration",
        "Body Fluid Composition": "so let's talk about the body fluid composition for the body to run efficiently certain parameters must be maintained the amount distribution and movement of body fluids the electrolyte imbalance and the amount of hydrogen and ions or the acid-base balance the total body water sixty percent of the total body weight uh for the healthy adult male it's made up of intracellular fluid and extracellular fluid so intracellular fluid is 67 of the total body weight and extracellular fluid is 30 37 of the total body weight it contains large amounts of sodium chloride and bicarbonate ions plus nutrients for the cells such as oxygen glucose fatty acids and amino acids",
        "Cellular Transport Mechanisms": "so cellular transport mechanisms so to maintain homeostasis the body must maintain a delicate balance among the fluid compartments the fluids in the body exist in a solution of dissolved elements and water the cell membrane is semi-permeable allowing lipid soluble substances to move in and out of the cell freely while not allowing water-soluble substances to cross the membrane so water and electrolytes move among the fluid compartments of the body according to some basic chemical and biological principles so balance across the cell membrane has two components you have balance of compounds on either side of the cell membrane and balance of the charges and the charges carried on the atoms on either side of the cell membrane when concentrations of charges or compounds are greater on one side of the cell membrane than on the other a gradient is created the process of flowing down a gradient depends on whether the cell membrane will allow the material to pass through remember we said some compounds travel freely while others require active transport each of the compartments of the body is separated by a membrane you have osmotic pressure and the pressure exerted by the concentration of the solutes in a given space to stop the flow of the solvent across the semi marble semi permeable membrane the process of particles moving from an area of higher concentration to an area of a lower concentration along a concentration gradient until equilibrium is is achieved so it does not require energy it's considered passive how the body is able to move some nutrients and waste products in and out of the cell",
        "Filtration": "filtration is commonly used by the kidneys to clean blood water carries dissolved compounds across the cell membrane to the tubules of the kidney the tubule membrane traps these dissolved compounds but allows the water to pass through this process cleans the blood and wastes and removes trap compounds from circulation",
        "Facilitated Diffusion": "facilitated diffusion so you have passive transport mechanism that involves particles moving from areas of high concentration to areas of lower concentration the molecule entering the cell cannot enter without the assistance of a carrier protein the molecule and carrier protein may be lipid soluble and pass through the membrane or the two may enter the cell through the membrane protein",
        "Osmosis": "osmosis is a movement of a solvent so like the water from an area of a low solute concentration to one of high so osmosis is a passive transport mechanism however unlike diffusion the particles themselves do not move okay so the body tries to maintain an equal solute concentration on each side of the membrane so you have different ways that it does this you have the isotonic solution you have toxicity osmotic gradient and hypertonic so the concentration of one of the solute is higher within the cell than outside and the hypotonic so that's when the less solute is present within the cell than outside and so creation that's too much water moves out of the cell and the cell shrinks abnormally and then lysis is when too much water enters the cell and the cell will burst",
        "Active Transport": "active transport so it's transportation of ions and molecules from an area of low concentration to an area of high you have expenditure of energy and it's required because of the uphill movement an active transport process is a sodium potassium pump it must be used to move these ions across their concentration gradient after the particle is bound with a carrier protein it is transported through the membrane and then released you have endocytosis and that's the secretion from the cell membrane it moves particulars too large to enter the cell by other processes within a vesicle of the cell so and then you have exocytosis and that's the opposite process of endocytosis and a substance is stored in the vesicle is secreted from the cell",
        "Types of Tissues": "okay so now we're going to move on to tissues there's four major types of tissues we have epithelial connective muscle and nervous epithelial tissue covers the body's surfaces connective tissues are widely distributed throughout the body they're filling the internal spaces and function to bind support and protect the structures muscle tissues is the contractual tissue and it includes skeletal muscles heart and muscular walls of the hollow organs and then nervous tissues of the body they have the ability to conduct those electrical impulses and allow for communication okay so of those tissues",
        "Epithelial Tissues": "the first one we're going to talk about is the epithelial tissues and the epithelium covers most of the surface of the body both external and internal surfaces and the interior of hollow organs so the epithelium is composed of many cells that fit together forming a continuous layer they perform four essential functions so their physical protection permeability sensation and specialized secretion such as gland cells okay so epithelial tissues are classified by their shape their microscopic shape and um so you have squamous cubicle columnar and the transitional and then you have the layers so you have the simple stratified epithelium and pseudostratified and epithelial tissue is sometimes subdivided into membrane epithelium and glandular epithelium and membrane epithelium covers the body and glandular epithelium it consists of the specialized cells that produce and secrete substances into ducts and body fluids so the next tissue is the connective tissue it's the most abundant type of body tissue and most widely distributed they vary greatly in appearance and have several functions so they bind body structures provide support and protection create frameworks they fill body spaces they store fat produce blood cells and transport fluids and dissolve materials they repair damaged tissues and then they protect the body from infection there are three basic components you have specialized cells extracellular protein fibers and a fluid known as a grand substance they're composed of cells that are separated from each other by a matrix which gives the tissue its characteristic and amounts of the majority of connective tissue it's a bone cartilage and fat three connective tissue fibers produced by those fibroblasts there's the collagen fibers and those are important in ligaments and tendons elastic fibers and they are common in body parts that are often stretched such as vocal cords and then there are the rectal fibers they are for delicate supporting networks in the spleen and other tissues okay so there's other types of cells found in connective tissues there's the mast cells microphanges adipose and the melanocytes and those are specialized cells in deeper epithelium of the skin responsible for the production of melanin all right so connective tissues there are three categories of connective tissues and they are connective tissue proper supporting connective tissues and fluid connective tissues connective tissue proper is divided into dense and loose supporting connective tissue protects soft tissues or or summer all of the body's weight and includes cartilage and bone and then you have fluid connective tissues so that's the blood or the lymph they have cells suspended in the water matrix the figure shows types of typical connective tissues",
        "Muscle Tissues": "okay then we have the muscle tissues muscle tissues it's contractile tissue and is uh the basis of movement of the body there are three types you have skeletal smooth and cardiac say skeletal muscle tissue is voluntary muscle i always say because you could pick stuff up and put it down that's you're using your skeletal muscle the smooth muscle is involuntary and those are the ones in those hollow internal organ walls and they also are in the blood vessels okay so all the tubes of the body then you have the cardiac muscle tissue that's called the myocardium that is the thick contractual middle layer of the heart wall and remember it's involuntary you cannot choose who you fall in love with that's how i remember it's a voluntary muscle",
        "Nervous Tissues": "all right moving on we have nervous tissues nervous tissue has the ability to conduct electrical impulse and allow communication between the body structures and control the body functions so nervous tissues contain two basic types of cells you have neurons or neuroganglia or ganglia cells",
        "Types of Membranes": "the types of membranes so membranes form a barrier or on an interface so epithelial membranes are thin structures they're made up of epithelium and underlying connective tissues that cover body surfaces and line body cavities remember we have four basic types of membranes we have the serious mucus penis and the synovial",
        "Homeostasis": "all right so let's get into homeostasis it's an adaptive response to various stimuli it allows the cells and tissues to respond and function within their respective environments in a constant effort to preserve a degree of stability or equilibrium homeostasis is from the greek words for same or steady it's also called the dynamic steady state so the body maintains homeostasis through cell turnover a regulatory or counter-regulatory system control of internal body temperature regulation of ph and acid base and balance of water or hydration in the organism cells of the body so the physical cell turnover so it refers to the process in which the older cells are eliminated and replaced by newer cells it's normal cell death the regulatory system so for every cell tissue or organ that performs one function at least one component exists that performs an opposing function and that's called the counter regulatory system regulatory systems communicate with the body at a cellular level so cells communicate through cellular signaling the signaling triggers chemical reactions in the receptor cells that initiate a biological action so when the action is has been completed the opposing system is alerted to stop the action through a process called feedback inhibition or negative feedback you have a thermostat mechanism there's five primary mechanisms that help the body reduce excess temperature eliminate heat convection conduction radiation evaporation so when it comes to respiration the thermostat of the body balance the generation of heat with the elimination of heat the body human body maintains homeostasis by balancing what it takes in and what it puts out so the body takes in chemicals and electrolytes food and water when normal cellular signaling is interrupted disease occurs okay so counter regulatory mechanisms are rendered ineffective regulatory systems begin to operate autonomously and the system stops providing critical negative feedback instead it gives a unopposed positive feedback",
        "Organ Systems": "okay so organ systems an organ system is composed of at least two kinds of organs that are organized to perform a more complex task than a single organ can the 12 major major organ systems of the body include the intermegatory skeletal musculoskeletal nervous endocrine circulatory lymphatic immune respiratory digestive urinary and reproductive systems",
        "The Integumentary System": "so let's go through these systems the intermegratory system is the largest system on the body it serves as the interface between the body and the outside world and it consists of the skin and the accessory structure such as hair nails subcutaneous glands and sweat glands it has a critical role in maintaining the consistency of the internal environment and does so by performing the following functions it protects the body in the environment temperature regulation fluid regulation sensation and inflammatory response so the skin covers the entire external surface of the body except the orifices such as the mouth nose anus and vagina the orifices are lined with mucous membranes which provide a protective barrier against bacteria um but also secrete mucus so mucous membranes are moist but skin is dry and the mucous membrane lines the entire gastrointestinal tract it's the largest organ there are two layers so the epidermis and the dermis the subcutaneous tissue is below the skin and that's composed largely of fat which serves as an isolator and reservoir to store energy the figure shows the principal layers of the skin the epidermis that's the most superficial layer of the skin the varies in thickness in different areas of the body and so it's composed of several layers of cells that can be separated into two regions um you have the stratum corneum and that's the cells are dead and they have their cytoplasm reduced or replaced with keratin and then you have the germinal layer that's the the dermal layer is the only location in the dermis in which the cells are able to undergo mitosis the dermis the dermis lies below the epidermis there are two layers and they're joined by the dermal epidermal junction the dermis is much thicker than the epidermis it connects the can consists of connective tissue containing both collagen and elastin fibers which connect the cells together the dermis is also subdivided in the two layers the populatory layer in the rectilinear layer the vasculature inside the papillary dermis serves two functions it provides nutrients to the dermis and aids in thermal regulation so the dermis contains the following structures nerve endings blood vessels sweat glands hair follicles and the sebaceous glands okay so the skeletal system the",
        "The Skeletal System": "integrated structure formed by 206 bones of the body you have the functions of it it's the support leverage and protection of the body storage maintenance of calcium levels and blood cell production there's two distinct portions of the skeletal system you have the axial and the appendicular okay so the axial is composed of that central part and the appendicular are the bones of the upper and lower extremities and then the connections to the axial so you have the shoulder girdle and that's in the upper extremities and then in the lower extremities you have the pelvic girdle so girdles connect the axial and the appendicular the major structure of the system is the bones and it contains cartilage tendons and ligaments and they're important connective tissues that help provide the structure framework of the skeleton okay so when the muscle contracts the tendons pull on the bone resulting in a motion at the joint and that's the point where the two or more bones come together allowing movement to occur",
        "Types of Bones": "there are characteristics and compositions of the bones so they're classified by their shape we know there's long bones and short bones so those long bones are the humerus ulna radius and femur and the short ones are those phalanges metacarpals and tarsals those are in the feet and the hands you also have flat bones and that's like the sternum and the ribs and the scapula and then you have the irregular bones and those are like the mandible which is the lower jaw and the facial bones also vertebrae in the spine and pelvis there are common characteristics of each type of bone there are two main ones so you have the compact bone and that's the solid part and then you have the calcius bone and that's the spongy part there are three regions of long bones you have the diaspheres the epi epithesis and the metaphyses the peristinum that's the double layer of connective tissue it lines the outer surface of the entire bone and it contains a rich supply of blood vessels lymphatic muscles nerves bone cells and elastic fibers",
        "Bone Formation and Growth": "when it comes to bone formation and growth bone is a type of connective tissue bone is composed of bone cells and matrix and there are three types of those cells in the bone it's the osteoblast the osteoclasts and the osteocytes long or bones begin to form in utero at six weeks and bones forming cells which are the osteoblasts develop they deposit bony matrix around them and once the matrix is surrounded by osteoblasts they're called osteocytes",
        "Growth and Development of Bones": "the process of replacing other tissues with bone is called ossification and the process of bone formation is called endochondrial ossification joints those are the articulations and they're formed",
        "Joints": "whenever two long bones come to connection they consist of the ends of the bones that make up the joint and the surrounding connective and supporting tissues joints allow for movement and most joints are named for the bones that form them for example the sternal clavicular joint and that's the articulation between the sternum and the clavicle types of joints are classified by structure and let's take a look so the 230 joints in the body are summarized as following so you have the fibrous cartilaginous joints the synovial joints the figure shows the joints of the body a bursa is a small pad like sac or cavity filled with a small amount of fluid that helps reduce the friction between a tendon and a bone or between a tendon and a ligament",
        "Axial Skeleton": "okay so let's talk about the axial skeleton that remember we said that was the center part and that's composed of the skull thoracic cage and the vertebrae column it's uh the brain within the skull and the heart and the lungs and the great vessels within thorax the thoracic cavity the spinal cord that's contained within the protected um but bony spinal canal it connects the brain to the skeletal muscle skin and other structures by means of spinal nerves",
        "Skull": "you have the skull the skull is at the top of the axial skeleton the skull contains 28 bones and three anatomic groups the bones of the skull are connected at special joints called sutures the figure shows the components of the skull front view and the bottom view okay you have the auditorial ossicles and that's six bones that form hearing three are located on each side of the head deep in the cavities of the temporal bone you have the cranial bones and the cranial vault consists of eight bones that encase and protect the brain you have the facial bones and they contain the orbits or eye sockets the nasal bones the zegmona the maxilla and the mandible the bones of the skull are connected at joints called sutures and the floor of the cranial vault is divided into three compartments on either side of the four magnum that lie the occipital condyles on the occipital bone which are part of the articulation of the connection between the skull and the vertebral column portions of the maxilla and the irregularly shaped bone in the bacterial posterior nasal cavity form the hard palate which is the bony anterior part of the plate palette so the facial bones you have 14 facial bones they form the structure of the face the facial bones protect the eyes nose and tongue the facial bones consist of the maxilla the mandible the zymo zagmotic bones the palatine bones the nasal lacmol and the vulmer the inferior nasal so both the frontal and the ethmod bones contribute to the cranial vault and the face okay so the skull still the facial portion of the cranial contains two orbits so the orbits contain the eyeballs muscles that move it and the blood vessels and nerves and fat the bones of the right and left upper jaw bone so that's the maxilla are located between the orbits of the upper teeth the mandible joints the skull to form the temporal mandib mandible joint so the tmj the mandible is the only facial bone that has a that's capable of movement the nose is made up of bones and cartilage you have the nasal cavity cavity that comprises portions of the facial bones the nasal septa septum separates the nostrils and the perinasal sinuses those are the contents drain into the nasal cavity the hyoid bone is not actually part of the skull it floats beneath the mandible with the open end of the horseshoe pointed posterior it supports the tongue and serves as the point of attachment for many other important neck and jaw and tongue muscles",
        "Neck": "the neck that's supported by the cervical spine the cervical spine is there's four cervical vertebrae in that column the esophagus and the trachea which is a windpipe is midline of the neck and on either side of the trachea are the the carotid arteries the jugular veins and nerves useful landmarks of the neck so you have the adam's apple that's the firm prominence in the center of the interior surface of the neck it's the upper part of the thyroid cartilage and it's more prominent in men okay so you have the cricoid cartilage it's more prominent in men it's a firm ridge of cartilage cartilage inferior to the thyroid cartilage you have the cricoid thyroid membrane it's a soft depression made of a thin sheet of connective tissue it's the fossa and it's um then you have the larynx it's the joint box okay so inferior to the larynx or the voice box are the cartilage rings of the trachea the trachea connects to the larynx with a main air passage to the lungs and on either side of the lower larynx the upper trachea lies the thyroid gland unless the gland is enlarged it's not usually palpable",
        "Vertebral Column": "all right so the vertebral column that's the spinal cord and it's encased by the vertebral column so the vertebral column is composed composed of 33 bones from top down the spine is divided into five sections and we say i always in order to remember these i always say it's when we eat during the day so you have first one you have the cervical spine or the c-spine that you have the first seven so you eat at seven a.m then you have the thoracic spine and of course that's 12 you eat at noon that's one pair of each ribs it's attached to each side of that thoracic vertebra then the lumbar you have five so you eat again at five pm then you have the sacrum that's one bone it's formed by five saccharo vertebra and then the coccyx so that's forms the last four together they're fused together i think of those as fused and so i always think of nine so five of the sacred and five of the coccyx so the figure shows the sections of the spinal cord you can see the numbers except for c1 the cervical vertebrae consists of a round anterior portion called the body with which the weight-bearing component of the spine so the posterior part of the vertebra forms the vertebral arch the vertebral arch serves and the following function so it serves as a connection point and allows for muscle movement vertebrae is connected by ligaments and between each vertebrae is a cushion called the intervertebral discs then you have the thorax so the thoracic consists of a bony cage overlying some and of most of the vital organs of the body so you have the heart lungs and great vessels that are contained in the thorax the thorax is defined by the following so you have the thoracic vertebra in the ribs you have the diaphragm and then you have the ribs and the thoracic inlet the bony structures of the thoracic include the sternum clavicle scapula thoracic vertebra and the 12 ribs the space superior to the mandiburum is the suprasternal notch it's also known as the jugular notch the junction of the mandarin and the sternal body is the angle of louie okay so the mediastinum contains the heart rate vessels part of the esophagus lymphatic channels trachea primary bronchi and the pair of vagus and phrenic nerves the heart lies immediately behind the sternum and we call that retrosternum retrosternal superior inferior vena cava is uh it carries the blood to the heart and the esophagus lines behind the great vessels there are 12 matched pairs of ribs the pairs of ribs attach posteriorly to the 12 thoracic vertebrae anteriorly the first seven pairs of ribs or the true ribs attach directly to the sternum via the costal cartilage the costal cartilage then continues inferiorly from the fourth rib and provides an indirect connection between the anterior portions of the eighth ninth and tenth ribs those are false ribs and the sternum",
        "Appendicular Skeleton": "and then you have the appendicular skeleton and that's of course the bones of the shoulder and pelvic girdles the upper and lower extremities the shoulder it attaches the upper extremity to the body it's made of the scapula and clavicle and i always say the shoulder girdle you have a girdle in that at that girdle is where the appendicular and the axial skeletal meet and you have the pelvic girdle and of course that's uh um it serves as the attachment for the upper extremities to the axial skeleton you have the humerus and that's the bone of the upper arm it articulates with the scapula then you have the forearm and the wrist and that extends from the elbow to the wrist the forearm contains two bones the radius and ulna then the wrist contains the following eight bones those are cart carpels you have the carpal tunnel and it's formed by a space bounded by a little area um and there's connective tissue that forms the roof of the carpal tunnel um on the palmer side so the palm side then the hands you have the metacarpals you have the metacarpal joint of the thumb um the plexis and you have blood supply to the upper extremity and um the blood supply originates in the subclavian artery artery and then you have the pelvis it's called the pelvic girdle it's a ring formed anteriorly from a fusion of the iip that's how i remember it's a ilium ischium and pubic bones on either side of the body supports the weight of the trunk and serves as a place of attachment for the thighs and protects the organs of the pelvic cavity including the intestines urinary bladder and internal reproductive organs then moving down we have the lower extremities the lower extremities includes the thigh knee ankle foot and toes um the leg the leg is made up of the tib and fib and above that of course is the femur and uh the tibian fib is longer and the tibia is longer and thicker than the fib and is on the anterior surface of the leg that's the tibia okay so then you have that lower extremity still we're still talking about that we have the knee and the knee is a hinge joint it is unusual because it contains ligaments within the joint moving down we have the ankle and it's formed by articulation of the talus with the tibia amphibia it's made up of seven bones called tarsals instead of the carpals up in the hand these are the tarsals all right as you have an ankle joint surrounded by a fibrous capsule movements include dorsiflexion plantar flexion and it's limited to inversion and aversion okay then you have the metatarples and phalanges of the foot they're like the bones of the hand so the toes have three phalanges each except the big toe which only has two then you have the ball of the foot okay moving into the last section that we're going to talk about in part one this is going to be the skeletal aspect and this is probably my favorite uh part of the systems and so basically the musculoskeletal refers to the bones which we just talked about and the voluntary muscles of the body muscles are a form of tissues that allow for body movements there are over 600 muscles in the musculoskeletal system and the musculoskeletal system serves three important functions so movement and maintenance of posture joint stability and production of heat the skeletal muscles form the major muscle mass of the body it is called the voluntary muscles and i always say it's because direct control and it's voluntary so you could pick stuff up you could put stuff down you voluntarily go to the gym right so movement of the body results from skeletal muscle contraction and relaxation skeletal muscles vary greatly in size and shape and it also constitutes the muscles of the tongue soft palate scalp fairness upper esophagus and eye skeletal muscles cells possess the following properties that relate to their function so you have the excitability contractility extensibility and elastic elasticity so when you talk about components of the connective tissue the skeletal muscle is in is considered an organ of the muscular system its function is to contract and create a pulling force a muscle is made up of hundreds of skeletal muscle cells bound together to form muscle fibers the fiber is surrounded by connective connective tissue so muscles are separated by muscular fossa or deep fascia located outside the at the epimyosum the many layers of connective tissue that enclose and separate skeletal muscle allow for a great deal of independent movement when it comes to the attachment they are skeletal muscles form attachments to either structures to other structures either directly or indirectly so direct attachment is formed with extensions and indirect is formed with extensions of tendons so one end of the skeletal muscle is fastened to a relatively immovable part at a movable joint the other end connects to a movable part on the other side of the joint so during contraction the insertion is pulled towards the origin so muscle function it's usually function in groups so nervous system stimulates the desired muscles to perform the intended function muscle that contracts to provide most of the movement is called the prime mover or agonist okay so other muscles synergists work with the prime mover to make its action more effective other muscles such as antagonists two prime movers causing movement in the opposite direction smooth body movement depends on the antagonist relaxing while the prime movers contract the figure shows the major muscle groups there are muscle fibers and those are thin fibers they're elongated cylinders with rounded ends so you have the saccharomyes they're made up of microfilaments that are formed by threats of contractual proteins and the myofilament proteins are actin myosin troponin and triple myosin myosin molecules are two protein strands with cross bridges that project outward so groups of myosin molecules make up a myosin filament so you have striated muscle is the name from the striations that you see in the skeletal and cardiac muscle the striation pattern of the skeletal muscles fibers contain two main parts you have light bands and then you have dark bands a central region is composed of a thick filament with a thickened area that consists of proteins and so the figure shows that contractual machinery of that muscle cell that we were just talking about on the other slide okay so when you talk about muscle contraction the motor nerve many nerve cells contain motor neurons and when the motor unit is a it's a group of muscle fibers um that are in enacted on by a motor neuron so when stimulated that motor unit contracts as a whole unit because the motor neuron axons are present throughout the fleshy part of the tissue okay so the impulse that stimulates this contraction enters the muscle cells or muscle fibers at the neuromuscular junction at this junction the muscle fibers of the motor unit create the motor end plate which has receptors from the neurotransmitter so the ach okay and they contract the contraction stimulus so an impulse that causes contraction of skeletal muscles is transmitted through the motor neurons as a nerve impulse or action potential when a cell is at rest ions transported in to and out of the cell creating an electrochemical gradient across the cell membrane and that's known as being polarized so during repolarization the cell reacts to or recreates that electrochemical gradient ach is synthesized in the cytoplasm of the motor neurons and released into the somatic clefts between the motor neuron axons and the motor and plates okay so during contraction of actin and myosin actin slides over the myosin leading to the term sliding filament theory so you have muscle tone so what we're going to talk about next and so skeletal muscles cause unique movements based on the joints and where the attachment points are so muscle tone is the amount of tension that is in that muscle at any one point of time with muscle relaxation it's caused by the decom position of the acetylcholine and the enzyme acidic choliners so when stimulus ceases calcium ions are transported back to that sarcoplasmic reticulum without calcium the actin and myosin leakage or linkage breaks and the muscle relaxes come to energy sources you have atp and is regenerated from adp and phosphate and muscles use glucose as energy to synthesize atp cellular respiration of glucose for energy basically oxygen use and death so oxygen is required for the breakdown of glucose in the mitochondria red blood cells carry oxygen bound to hemoglobin molecules one hemoglobin molecule reversely binds to four oxygens the pigment myogablin is synthesized in the muscles and combines with oxygen and temporarily stores it with strenuous exercise oxygen is used to synthesize adp as lactic acid increases and oxygen depth develops oxygen depth is equivalent to the amount of oxygen that the liver cells require to convert the lactic acid into glucose increase exercise results in muscles capacity for glycolysis and that's aerobic exercise increases the muscles capacity for aerobic respiration but muscle fatigue so prolonged exercise may cause a muscle to become unable to contract lactic acid accumulation is the usual cause of muscle fatigue and then you have heat production so the energy required by muscle contraction is developed during the breakdown of atp and basically it's it's breaking of bonds so one of the byproducts of this breakdown is heat which is used to maintain the normal body temperature the temperature the body temperature drops below a certain set point then the nervous system stimulates the muscles to start shivering to develop a heat and elevate basically the body temperature okay so this concludes the first part of the basically the anatomy and physiology and we're gonna do part two it starts with the nervous system and continues through all the other systems and i'll be adding that in a few short hours thank you for joining me if you like this screencast go ahead and like my channel we're going to be adding like i said all the other chapters have a great day"
    },
    {
        "Introduction to Anatomy and Physiology": "chapter 7 the human body anatomy is a fundamental branch of biological science that focuses on the structural organization of living organisms it encompasses both gross anatomy which involves the study of macroscopic structures such as organs and tissues visible to the naked eye and microscopic Anatomy which examines minute anatomical components including cells and tissues observable only through microscopic techniques physiology on the other hand delves into the functional aspects of these anatomical structures exploring the various biochemical physical and mechanical processes that sustain life together anatomy and physiology provide a comprehensive understanding of the intricate architecture and dynamic functions that categorize living organisms",
        "Cell Structure and Function": "cells the basic basic functional units of the body exhibit significant diversity in their morphology and roles as they mature through differentiation cells become specialized to fulfill specific functions essential for the organism's survival these specialized cells with similar functions aggregate to form tissues subsequently multiple tissues that collaborate to perform interconnecting tasks constitute organs a series of organs working synergistically contribute to body systems each of them essential for maintaining homeostasis fundamental cellular processes include excretion where cells eliminate waste products and respiration where they facilitate gas exchange for energy production additionally cells engage an intricate cellular signaling communicating electrochemically with both their structures and with other cells this ensures a coordinated and efficient functioning of the body systems cell structure is categorized into two general classes sex cells and sematic cells sex cells also known as gamuts are involved in reproduction and include sperm and OVA which combine during fertilization to form a zgat sematic cells which constitute the majority of your body cells form the tissues and organs responsible for various physiological functions Central to cell function is the nucleus which is a membrane bound organel that houses genetic material in the form of DNA the nucleus serves as a control center of the cell regulating gene expression cellular growth and replication thereby orchestrating the cell's activities in ensuring proper functioning and maintenance of the organism",
        "Cell Membrane and Cytoplasm": "the cell membrane also known as the plasma membrane is a critical structure that encloses the cell maintaining its integrity and facilitating communication with the external environment it is composed of a phospholipid bilayer which consists of a hydrophilic phosphate head and hydrophobic fatty acid Tails creating a semi-permeable barrier that regulates the selective movement of substances in and out of the cell embedded within this by layer are various molecules that form specific Pathways allowing the transport of ions nutrients and waste products these Pathways also enable the detection and transmission of extracellular signals which are critical for cellular responses and interactions despite being extremely thin and delicate the cell membrane features tiny folds or microvilli which significantly increase its surface area enhancing its functional capacity this complex and dynamic structure is essential for maintaining cellular homeostasis and facilitating intercellular communication the cytoplasm a gel-like substance within the cell encompasses all cellular components outside the nucleus providing a medium where various cellular processes occur the cytool the fluid portion of the cytoplasm is predominantly composed of water but also contains essential biomolecules such as glucose amino acids fatty acids ions lipids proteins adenosine trios pH fate or ATP and metabolic waste products this composition supports numerous biochemical reactions that are vital for cellular functions in life",
        "Organelles and Their Functions": "organel which are specialized subunits within the cytoplasm perform distinct tasks that are crucial for the cell's structure growth maintenance and Metabolism these organel which include the mitochondria endoplasmic reticulum GGI apparatus and lomes work together to ensure the cell operates efficiently and responds appropriately to its environment organel execute specific and critical functions essential for cellular activities contributing to the overall health and functionality of the cell centrioles are cylindrical structures that play a pivotal role during cell division known as mitosis during this process centrioles move to opposite poles of the cell forming the spindle apparatus that's necessary for the accurate segregation of DNA strands into the daughter cells the presence of a pair of centrioles is indispensable for this process ensuring the equal distribution of genetic material cyia and fagula are hairlike appendages that extend from the surface of certain cells each serving distinct locomotive and sensory functions ayia are shorter and more numerous moving in coordinated waves to transport fluids mucus or cells across the tissue surface this is needed in respiratory and the reproductive tracts flatula which are usually longer and fewer in number are primarily responsible for propelling the entire cell such as sperm cells the coord orated movement of these structures is needed for the functionality of the many tissues and organs ribosomes are small dent structures composed of RNA and proteins they are the sites of protein synthesis where genetic information that's ecoded in messenger RNA or mRNA is translated into polypeptide chains which then fold into functional proteins these proteins are essential for various cellular processes including enzymatic activities structural functions and Signal Pathways",
        "Endoplasmic Reticulum and Golgi Apparatus": "the endoplasmic reticulum is a vast membranous Network that serves as a transportation and processing Hub within the cell it exists in two forms both smooth and rough the smooth endoplasmic reticulum lacks ribosomes on its surface and is involved in the synthesis of lipids metabolism of carbohydrates and the detoxification of drugs and poisons it also plays a role in calcium storage the rough endoplasmic reticulum is studded with ribosomes which give it a rough appearance under a microscope it's primarily involved in the synthesis and initial folding of proteins that are destined for secretion membrane insertion or lysosomal targeting collectively these organel ensure the cell's structural Integrity metabolic efficiency and adaptability to its environment they work in conert to maintain homeostasis respond to external stimuli and execute complex biological functions that are necessary for the survival and proper functioning of the organism the GGI apparatus also known as the GOI complex is a vital organel that's involved in the post transational modification sorting and packaging of proteins that are synthesized on the ribosomes it has three primary functions first it concentrates in packages secretions for exocytosis which ensures that substances are efficiently exported out of the cell second it ENC ulates specific enzymes within vesicles for use within the cytool which facilitates various intracellular processes third the GOI apparatus plays a crucial role in renewing or modifying the cell membrane maintaining cellular integrity and functionality",
        "Lysosomes, Microfilaments, and Mitochondria": "lomes are membranebound organel containing hydrolytic enzymes that break down cellular waste including nutrients and farm particles ensuring cellular cleanliness and the recycling of materials microfilaments which are composed of actin and myosin proteins provide structural support and facilitate cell movement and contraction through their interactions mitochondria which are often referred to as the PowerHouse of the cell have a double membrane structure that are critical for ATP production through oxidative phospher ation the smooth outer membrane encases the organel while the inner membrane which is characterized by folds called chiste increases the surface area for energy production processes the central fluid filled cavity known as The Matrix contains enzymes that are vital for the citric acid cycle and other metabolic pathways",
        "Peroxisomes and Vesicles": "peroxisomes contain in enzymes such as catalase and oxidase that catalyze various biochemical reactions including the breakdown of fatty acids and the detoxification of harmful substances thick filaments compos primarily of mein form massive bundles that are essential for muscle contraction and other motile functions within the cell vesicles or vacul are sacklike structures that are formed when parts of the cell membrane invaginate this plays significant roles in material transport storage and waste disposal within the cell these organel collectively orchestrate a myriad of cellular processes ensuring the cell's proper function growth and adaptation to its environment",
        "Nucleus and Genetic Material": "the nucleus which is the largest structure within the cell functions as the control center orchestrating cellular activities by regulating gene expression and maintaining genetic Integrity it houses the genetic instructions that are essential for the synthesis of proteins which are pivotal to the development structure and function of the cell these genetic instructions are encoded in the DNA which along with various Associated proteins forms chromatin within the nucleus the nucleoplasm which is a gel-like substance suspends the nucleis and chromatin the nucleis is involved in ribosomal RNA synthesis and ribosome assembly which are critical for protein production the structural organization of the nucleus with its DNA in protein complexes ensures the precise execution of genetic instructions thereby maintaining cellular homeostasis and facilitating cellular responses to environmental signals",
        "Cell Cycle and Division": "the life cycle of a cell is intricately regulated by hormones and growth factors which stimulate and control the progression through various stages most human cells undergo approximately 40 to 50 cell divisions before entering syence and eventually dying the cell cycle comprises several key phases interphase cell division or mitosis cytoplasm division or cyto canis and differentiation during interphase the cell undergos a period of preparation for division which is characterized by significant cellular activity this phase is essential for the cell to manufacture new bio molecules and replicate its genetic material ensuring that each daughter cell receive a complete set of DNA cell division encompasses two primary processes meosis and mitosis which is accompanied by cyto canis meosis is a specialized form of division that reduces the chromosomal number by half producing gamuts eggs and sperm necessary for sexual reproduction this reprod production is for maintaining the species specific chromosome number upon Fertilization in contrast mitosis involves a duplication of a cell to produce two genetically identical daughter cells maintaining the organism's chromosomal number cyto canis the division of the cytoplasm typically begins during the latter stages of mitosis and it involves the constriction of the cell membrane at the midline resulting in the formation of two separate daughter cells each containing a nucleus and a portion of the organel differentiation is the process through which cells become specialized acquiring distinct structural and functional attributes to make them unique this process is vital for the formation of various cell types that constitute the tissues and organs of an organism stem cells which have the remarkable ability to divide repeatedly without differentiating can give rise to identical daughter cells or partially specialized progenitor cells these cells can further differentiate into specific cell types contributing to tissue growth repair and maintenance under normal physiological conditions cell division and growth are balanced with cell death maintaining tissue home stasis however when cell division and growth surpass the rate of cell death tissues begin to enlarge potentially leading to the formation of a neoplasm which is a mass of tissue arising from abnormal cell growth and division neoplasms can be classified as benign or malignant a benign tumor which remains confined within the epithelium seldom poses a life-threatening risk and can typically be removed surgically in contrast a malignant tumor exhibits invasive Behavior spreading to the surrounding tissues this invasive process can lead to metastasis where malignant cells travel through the bloodstream or lymphatic system to establish secondary tumors in distant organs or tissues malignancy generally arises from genetic mutations in normal cells causing them to grow uncontrollably and lose their resemblance to normal cells as cancer cells proliferate they often stimulate angiogenesis the growth of new blood vessels to supply the tumor with nutrients and oxygen the progression of metastasis significantly impairs organ function disrupting the body's normal physiologic process and leading to severe Health consequences",
        "Cellular Respiration": "cellular respiration is a metabolic process through which cells extract energy from organic compounds primarily glucose using oxygen this process involves three main stages glycolysis the kreb cycle and the electron transport chain during glycolysis which occurs in the cytool of the cytoplasm glucose undergos a series of enzymatically catalyzed reactions resulting in the for of pervic acid and lactic acid in the absence of oxygen characterizing it as anerobic metabolism in the presence of sufficient oxygen peric acid enters aerobic respiration Pathways including the kreb cycle and the electron transport chain all of which are located in the mitochondria the kreb cycle further breaks down pervic acid producing carbon diox oide while the electron transport chain generates water as electrons are transferred through a series of protein complexes ultimately producing a significant amount of adenosine triop phosphate the complete oxidation of one glucose molecule during aerobic metabolism can yield up to 36 ATP molecules at the expense of four previous molecules allowing for a net of 32 ATP molecules all of which are vital for numerous cellular functions this figure shows anerobic metabolism versus aerobic metabolism during the process of anerobic metabolism which occurs in the cytoplasm the breakdown of glucose results in lactic acid during aerobic metabolism which occurs in the mitochondria the breakdown of glucose results in carbon dioxide water and ATP",
        "Kreb Cycle and Electron Transport Chain": "the kreb cycle also known as the citric acid cycle is a critical component of aerobic metabolism this cycle involves a series of enatic reactions that metabolize carbon chains derived from glucose fatty acids and amino acids it occurs in the presence of oxygen and takes place in the mitochondria Matrix when food is ingested macro molecules are broken down into simpler molecules proteins into amino acids carbohydrates into simple sugars like gluc glucose and fats into glycerol and fatty acids glycerol and amino acids are further metabolized into pervic acid during glycolysis and the subsequent KB cycle a total of four ATP molecules are are produced in the absence of oxygen cells can still undergo anerobic respiration which can lead to lactic acidosis especially during shock when oxygen supply is insufficient the electron transport chain is the final stage of cellular respiration taking place in the inner mitochondrial membrane it's responsible for producing 34 ATP molecules through an arobic process known as oxidative phosphation the electron transport chain involves a series of protein complexes and electron carriers that transfer high energy electrons derived from the kreb cycle and glycolysis for this process to occur both glucose and oxygen are required the energy from the electrons is used to pump protons across the mitochondrial membrane creating a protein grade that drives the synthesis of ATP by ATP synthes nearly half of the energy is recaptured in the form of ATP resulting in a total yield of 38 ATP molecules from one molecule of glucose through the combined process of glycolysis the kreb cycle and the electron transport chain",
        "Cellular Transport Mechanisms": "cellular transport mechanisms describe the processes by which materials move into and out of cells governed by the selective permeability of the cell membrane this selective permeability is vital for maintaining homeostasis allowing the cell to regulate its internal environment the cell membrane controls the passage of various substances including electrolytes which are salts or acids dissolved in the blood that play a key role in cellular function by permitting certain ions and molecules to cross while restricting others the membrane enables differences in concentrations between the intracellular and extracellular environments a condition known as the concentration gradient this gradient is critical for various physiological processes including nutrient uptake waste removal and Signal trans transduction the membrane's ability to selectively allow or prevent the passage of materials ensures that the cell can maintain its internal balance and respond to external changes effectively",
        "Diffusion and Filtration": "diffusion is a passive transport mechanism in which solute particles move from an area of higher concentration to an area of lower concentration driven by the kinetic energy of the particles this process Contin continues until an equilibrium is reached resulting in an even distribution of solute particles throughout the solution diffusion does not require cellular energy and occurs spontaneously due to the random movement of molecules it is a fundamental process in biological systems facilitating the movement of gases like oxygen and carbon dioxide across cell membranes as well as the distribution of nutrients and waste products within the cell and extracellular fluids the rate of diffusion can be influenced by factors such as temperature the concentration gradient and the properties of the membrane and solute particles filtration is a process by which substances are moved across a membrane or barrier driven by a pressure gradient in the human body this process is exemplified by the function of the kidneys the kidneys filter blood through structures called nephrons where blood pressure forces water and solutes containing waste products and excess substances across the Grom membrane into the renal tubles this filtrate is processed along the nefron to selectively reabsorb necessary substances back into the bloodstream while concentrating waste products ultimately these waste products along with excess water and solutes are excreted from the body in the form of urine filtration in the kidneys is vital for maintaining homeostasis regulating fluid balance electrolyte levels and in removing metabolic waste from the bloodstream",
        "Facilitated Diffusion and Active Transport": "facilitated diffusion is a passive transport mechanism in which carrier molecules assist in moving substances across cell membranes from areas of higher concentration to are is of lower concentration without the need for cellular energy or ATP the rate at which molecules are transported is directly proportional to their concentration gradient meaning that higher concentrations result in Faster transport rates unlike facilitated diffusion active transport requires energy to move substances against their concentration gradient additionally cells utilize endocytosis and exocytosis to transport large molecules or particles into and out of the cell without crossing the cell membrane directly endocytosis involves the engulfing of external substances into the cell and it occurs in three forms pinocytosis or cell drinking where the cell engulfs extracellular fluid phagocytosis or cell eating where the cell engu large particles or microorganisms and receptor mediated endocytosis where specific molecules are targeted and internalized after binding to cell surface receptors exocytosis involves the expulsion of substances from the cell by vesicles fusing with the plasma membrane releasing their contents outside the cell these process are essential for nutrient uptake waste removal and cell signaling this figure shows facilitated diffusion in a you can see particles move from the area of higher concentration to the area of lower concentration with the assistance of a protein while in B active transport uses energy from ATP to open a pathway for compounds to move against a concentration gradient",
        "Osmosis and Tonicity": "osmosis is a type of passid transport in which a solvent typically water moves across a selectively permeable membrane from an area of low solute concentration to an area of high solute concentration this movement occurs without the need for energy driven by the concentration gradient of the solute the selectively permeable membrane allows the solvent to pass through while restricting the passage of solute molecules creating a balance between the solvent and solute concentrations on either side of the membrane osmotic pressure is a measure of the tendency of water to move across a membrane by osmosis it reflects the potential pressure required to prevent water from moving across the membrane correlating with solute concentration a higher solute concentration results in higher osmotic pressure indicating a stronger pull on water molecules to move into the area of higher solute concentration osmosis plays a fundamental role in maintaining cellular homeostasis regulating fluid balance and ensuring proper cell function in biological systems tonicity refers to the concent ration of solutes in a solution and its capacity to attract or release water across a semi-permeable membrane hypertonic solution is a higher concentration of solutes compared to another solution leading to the movement of water out of cells placed in such a solution potentially causing shell shrinkage or crenation conversely a hypotonic solution has a lower solute concentration causing water to move into cells which can result in cell swelling and bursting a process known as lysis an isotonic solution has an equal concentration of solutes and water on both sides of the membrane maintaining cellular stability without net water movement",
        "Body Fluid Balance": "body fluid balance is maintained through the distribution of fluids within two m M compartments the intracellular fluid or ICF and extracellular fluid or ECF ICF which resides within cells constitutes approximately 40 to 45% of an individual's total body weight extracellular fluid located outside of the cell membranes accounts for about 15 to 20% the extracellular fluid is further subdivided into intracellular fluid and interstitial fluid intravascular fluid or plasma is found within the blood vessels it makes up roughly 4.5% of total body weight interstitial fluid occupying the spaces between the cells comprises about 10.5% of total body weight when fluid is lost from any part of the body it disrupts the balance between these compartments leaving to potential imbalances and health issues fluid balance is maintained through the equal intake and output of fluids ensuring homeostasis the sensation of thirst is a physiological response that occurs when body fluids decrease signaling the need for fluid intake Additionally the body can maintain fluid balance by shifting water between compartments to address immediate needs and restore equilibrium this intricate regulation is vital for maintaining cellular function and overall health",
        "Organ Systems Overview": "an organ is composed of at least two kinds of tissue that are organized to perform a complex task there are 12 major organ systems of the body all of which will be discussed in this lecture the 12 major systems are the integ material skeletal muscular nervous endocrine circulatory lymphatic immune pulmonary digestive urinary and reproductive the skeleton gives us our recognizable human form and protects our Vital internal organs bones constitute the major structure of the system and cartilage tendons and ligaments are the important connective tissues a tendon connects muscle to bone while a ligament connects bones to each other undoubtedly you've heard of injuries such as sprains and strains a sprain occurs when the bone ends partially or temporarily dislocate and the supporting ligaments are stretched or torn while a strain or a muscle pole occurs when a muscle is stretched or torn the cartilage acts as a cushion between bones but can wear down over time bones are classified according to their shape as either long bones short bones or flat bones long bones include the femur tibia fibula Onna radius and humorus short bones include the bones of the wrist and Ankle flat bones would be certain skull bones ribs sternum and scapula and in that category a subcategory known as irregular bones these have unique shapes and are designed to perform specific functions this would include the mandible a majority of your facial bones and those that comprise the the vertebrae in the spine and pelvis Additionally the small bones of the feet as well as the hands compose their own subcategory of short bones long bones consist of a shaft or the diaphysis ins epiphysis and growth or epical plates the growth plate is the major site of bone elongation the periostium consists of a double layer of connective tissue and lines the outer surface of the bone the ostium lines the inner surfaces the diaphysis of many bones includes the medullary cavity which is an internal cavity that contains the bone marrow the two main types of bone are compact bone and celis Bone compact bone is mostly solid with few spaces while canellis bone consists of a lacy network of bony rods called Tre Whenever two long bones come in contact a joint or articulation is formed a joint consists of the ends of the bones that make up the joint and the surrounding connecting and supporting tissue some joints have slight light limited Motion in which the bone ends are held together by fibrous tissue this is called a symphysis the bone ends of a joint are held together by a fiber Sac called The Joint capsule on the inner lining of the joint capsule is the sovial membrane this membrane produces a thick lubricant known as sovial fluid the shoulder joint is a ball and socket joint while your finger joints elbow and knees are hinge joints",
        "Skeletal System": "the skeletal system is divided into two main portions the axial skeleton and the appendicular skeleton the axial skeleton is composed of the skull thoracic cage and the vertebral column the appendicular skeleton is composed of the arms legs their connection points and the pelvis the heart lungs and great vessels are enclosed in the thorax or thoracic cavity the 206 bones of the skeleton provide a framework for the attachment of your muscles the skull consists of 28 bones in three anatomic groups the auditory ticles the cranium and the face six auditory ticles function in hearing with the remaining 22 Bones comprising the cranium and the face itself listed on the screen you'll see multiple bones we will concentrate on some of the more common ones you'll run into on patients with traumatic injuries the cranial Vault consists of the eight bones that encase and protect the brain this includes the parietal temporal frontal occipital sphenoid and ethmoid Bones the brain and spinal cord are connected through a large opening at the base of the skull called the framan Magnum the bones of the skull are connected together at special joints known as sutures fibrous tissues called fontel link the sutures together the floor of the interior of the skull is divided into three compartments the anterior fossa middle fausa and posterior fossa Christa gal forms a prominent bony Ridge in the center of the anterior fossa and on either side of the Chrystal Galley is the cryor plate of the ethmoid bone the olfactory nerve sends projections through the formina of the cryor plate and into the nasal cavity now let's take a look at the facial Bones the frontal and ethmoid bones are part of the cranial Vault and the face in total there are 14 facial bones that form the structure of the face and they include the maxill cible zygoma Palatine nasal lacrimal V and inferior nasal Contra Bones the facial bones protect the eyes nose and tongue the orbit is a bone-shaped fausa that encloses and protects each eye inside the fossa are blood vessels nerves and fat a blow to the eye may result in fracture of the floor of the orbit a blowout fracture can actually cause leakage of blood and fat into the maxillary sinus the nasal cavity comprises portions of several of the facial Bones the nasal septum is the separation between the nostrils and is located in the midline the nasal cavity contains cavities known as the paranasal sinuses sinusitis is an inflammation of the paranasal sinuses the mandible is a large movable bone making up the lower jaw and containing the lower teeth the posterior coni of the mandible articulates with the temporal bone at the temporal mandibular joint or T&J this allows for movement of the mandible the hyoid bone which is the only bone in the body that does not articulate with another one floats on the superior aspect of the neck and supports the tongue as well as the epiglottis this is the bone that is most commonly broken during choking or hanging the neck is supported by the cervical spine the upper part of the esophagus and the trachea lie in the midline of the neck with the cored arteries being found on either side of the trachea there are several landmarks that can be palpated and seen in the neck such as the atoms Apple which is the upper part of the thyroid cartilage as well as the lower portion of the CID cartilage between the thyroid cartilage and the CID cartilage in the midline of the neck is a soft Depression known as the cryo thyroid membrane which is the site of surgical Airways the stoco mastoid muscles originate for the mastoid process of the cranium and insert into the medial border of each collar bone and the sternum at the base of the neck the spinal column is the central supporting structure of the body from the top down the spine is divided into five sections the cervical spine are the first seven vertebrae C1 through C7 the thoracic spine are the next 12 T1 through T12 the lumbar spine are the next five the L1 through L5 the sacrum is composed of five fused vertebrae S1 through S5 and the coxic the last three to five vertebrae the first cervical vertebrae or C1 is called the atlas it articulates with the occipital condil at the base of the skull at the atlanto occipital joint the second cervical vertebrae or C2 known as the axis is the point at which the head rotates it's important to remember that the spinal cord is an extension of the brain specifically the brain stem it's is contained within and protected by the vertebrae of the spinal column the interior part of each vertebrae consists of a round solid block of bone called the body and are connected by ligaments in between each vertebrae is a cushion called the intra vertial disc the thorax is made up of the 12 thoracic vertebrae and 12 pairs of ribs the boundaries of the thorax are the rib cage anteriorly superiorly and posteriorly with the diaphragm being the inferior boundary in the anterior midline of the chest is the sternum the upper section of the sternum is called the manubrium the body comprises the rest of the sternum except for the narrow calines tip inferiorly which is known as a zyo process the largest structures within the thoracic cage are the heart lungs and great vessels just beneath the manubrium of the sternum the arch of the aorta and the pulmonary artery exit the heart the esophagus lies behind the great vessels and directly on the anterior aspect of the spinal column all space within the chest that is not occupied by the heart great vessels and esophagus are are occupied by the lungs the appendicular skeleton includes bones of the shoulder and pelvic girdles the upper extremities and the lower extremities the shoulder girdle attaches to the upper extremity to the body at the gleno humoral joint the two major components of the shoulder girdle are the scapula and clavicle the raised tip of the scapula is called the Acron process the shoulder joint is made up of a ball and socket joint in which the head of the humoris articulates with the glenoid fossa a Bersa is a pad-like sack that's situated between a tendon and the bone and cushions and protects the joints this is most often injured in patients who have dislocated shoulders the upper extremity consists of the arm forearm wrist hand and fingers the humoris is the largest bone and is located in the upper arm this is where our IO placement goes on upper extremities the forearm extends from the elbow to the wrist and contains the bones radius and alna the radius is located on the lateral of the forearm when the forearm is in the anatomic position the Ona is more narrow and located on the little finger side the wrist is made up of a group of eight irregularly shaped bones known as carpes structures within the carpal tunnel include the long flexor tendons to the fingers and the median nerve metacarpal bones form the hand with GES being a series of small bones that exist in each finger the carpo metacarpal joint of the thumb is a saddle joint and consists of two saddle-shaped articulating surfaces the pelvic girdle is where the lower extremities attach to the body they contain a ring of bones that are formed by the sacrum and the coxal bones each coxa consists of three fused Bones the ilium isum and pubis the pelvis contains three joints the two posterior sacroiliac joints and the inferior midline pubic symphysis the obturator Forin is an opening between the isum and the pubis and consists of several important nerves and muscles the pelvic girdle supports the body weight and protects the internal organs the lower extremity is made up of the hip thigh knee leg ankle foot and Toes the acetab Bellum is the socket of the ball and socket joint that connects the pelvic girdle to the lower extremity the femur is the longest and strongest bone in the body the uppermost portion of the femur the femoral head articulates with the pelvic girdle at the acetab Bellum in addition to the femoral head the proximal femur consists of the neck greater tranter and the Lesser tranter an articular capsule is supported by three ligaments that are quite strong at the distal end of the femur the lateral and medial Condes articulate with the proximal tibia of the knee the patella lies within the major anterior tendon of the thigh muscles and articulates with the femur the lower leg is made up of the tibia and fibula the tibia is the stronger and thicker of the two bones with the mediom malis lying at the distal end of the tibia the fibula runs behind and beside the tibia an enlargement of the distal end of the fibula forms the lateral wall of the ankle joint called the lateral malleolus the knee is traditionally classified as a hinge joint the interior cruciate ligament prevents abnormal anterior movement or hyperextension of the tibia several tendons as well as collateral ligaments add additional strength to the knee joint the Talis articulates with the tibia and fibula to form the ankle a fibrous capsule surrounds the ankle joint the metatarsals and fanges of the foot are arranged in a similar fashion to the bones of the hand physiologically the skeletal system is responsible for several functions bones protect internal organs and with the muscles enable movement various bone cells use calcium to create a structure that is hard and resilient bones themselves consist of collagen and the mineral Hydro zipolite collagen fibers and Bone lend flexibility and strength to the bones themselves the bones also help with the creation of various types of blood cells and it's important to remember that bones themselves are a living substance and the cells of the bone require a blood supply",
        "Muscular System": "the muscular skeletal system is essential for providing form maintaining upright posture and enabling movement of the body the system comprises bones and voluntary muscles also known as skeletal muscles there are more than 600 muscles within the muscular skeletal system each contributing to various functions such as locomotion stability and the manipulation of the environment the skeletal muscles are under conscious control allowing precise and coordinated movements in addition to the muscular skeletal system the body contains other types of muscles that operate involuntarily smooth muscle that's found in the walls of internal organs such as the intestines and blood vessles and the cardiac muscle found in the heart function without conscious effort these muscles are responsible for various vital functions including peristalsis blood circulation and maintaining heart rhythm together these muscle types ensure the body can perform a wide range of activities that are necessary for survival and interaction with the environment",
        "Skeletal Muscle Function": "skeletal muscle encompasses all the muscle attached to the skeleton that facilitates movement and maintains posture these these muscles also known as stri AED or voluntary muscles can be consciously controlled skeletal muscles vary significantly in size and shape allowing for a wide range of functions from gross motor movements to fine motor skills when muscles are not regularly used they do tend to atrophy a process that's characterized by the reduction of muscle mass and strength conversely consistent physical training promotes hypertrophy where the muscle fibers increase in size and strength most skeletal muscles operate on the principle of antagonistic pairs where one muscle contracts while the opposing muscle relaxes enabling smooth and coordinated movements for example the biceps and triceps in the upper arm function antagonistically the biceps contract to flex the arm while the triceps contract to extend it understanding the interplay between these muscle groups is fundamental in analyzing movement and diagnosing muscular disorders it's important to remember that muscles need energy to move muscle fibers have just enough ATP for short-term contraction and ATP must be regenerated when fibers are active using existing ATP molecules in the cells ATP is regenerated from adenosine diphosphate and phosphate when ATP breaks down energy from creatin phosphate is transferred to ADP molecules to then be converted back into ATP oxygen is required for the breakdown of glucose in the mitochondria one hemoglobin molecule reversibly binds with four oxygen molecules the pigment myoglobin is synthesized in the muscles and can combine with oxygen and temporarily store it to reduce muscular requirements lactic acid is a by product of anerobic metabolism and can accumulate in the muscles it will then diffuse into the bloodstream oxygen debt is equivalent to the amount of oxygen that liver cells required to convert the lactic acid into glucose as well as the amount needed by muscle cells to restore ATP and creatinine phosphate levels the sensation of muscle fatigue occurs when the energy supply to the muscle is inadequate to meet the energy demands",
        "Respiratory System": "the respiratory system encompasses all of the anatomical structures involved in respiration facil facilitating the exchange of gases between the body and the environment the upper Airway includes several key components the nose mouth tongue jaw oral cavity Linex and ferx these structures play a role in the intake and conditioning of air before it reaches the lower respiratory tract the mouth and nose serve as the primary entry points for air which is then warmed and filtered the tongue and jaw assist in manipulating the air and food intake ensuring that the pathways for respiration and digestion are appropriately managed the oral cavity acts as a conduit for air to travel through the ferx and Linex the Linex commonly known as the voice box contains the vocal cords which vibrate as air is forced past them producing sounds necessary for speech the ax serves as a shared pathway for both air and food directing air towards the respiratory tract while guiding food toward the esophagus the tongue is attached to the mandible and hyoid bone the pallet forms the roof of the mouth and separates the aeric and the nasofix the lateral borders of the glotus are the vocal cords and the lerx is typically considered the dividing line between the upper and lower airway with the glaic opening being the fine point of delineation the nose and mouth lead to the orenic while the nostril itself leads to the nasopen all fractory receptors located in the epithelium of the nasal cavity are responsible for recognizing odors the esophagus and the trachea are located at the bottom of the ferx the epig glotus is a leaf shaped valve that allows air to pass into the trachea but prevents food and liquid from entering the trachea the thyroid cartilage what we have discussed previously is the interior part of the Linex the lower airway contains the trachea bronchial tree Alvi and lungs this is where gas exchange occurs the inferior aspect of the thyroid cartilage articulates with the CID cartilage or CID ring the cryo thyroid membrane is located between the thyroid cartilage and the CID ring and is a site of our surgical Airways the first ring of the trachea is identified as the CID cartilage at the level of the fifth thoric vertebrae the trachea branches into the right and left main stem bronchi this is known as the Corina beyond the Corina air enters the lungs through the right and left main stem bronchi the point of entry for the bronchi blood vessels and nerves into each lung is called the hilum from there the main stem broni divide into the smaller secondary broni which then divide even further into the smaller tertiary Bron Bron ey after several generations of successive branching bronchioles which are extremely small subdivisions of the bronchi will then form each bronchioli divides to form lvlr ducks with each duck ending in a cluster known as Alvi there is pulmonary surfactant found in and around the V to reduce surface tension and increase pulmonary compliance and to prevent adelais at the end of expiration adelais is the collapse of the Alvi the pulmonary capillary membrane lies between the alvus and the capillary and is also known as the alvolo capillary membrane the lungs are surrounded by a membrane of connective tissue known as the plora the parial plura lines the plural cavity and covers the thoracic wall and Superior face of the diaphragm while the visceral plura covers the external surface of the lungs there is a potential space known as the plural space that exists between the visceral and parial plura the primary muscle of breathing is the diaphragm and it's Unique because it has characteristics of both voluntary and involuntary muscle movement the diaphragm performs an automatic function other muscles involved in breathing are the intercostal muscles the abdominal muscles and the pectoral muscles during inhalation the diaphragm and intercostal muscles contract during exhalation they relax the process of breathing is typically easy and requires very little muscular effort but still does require ATP there are some diseases that are associated with the anatomy of physiology that we're talking about chronic bronchitis results from the overgrowth of the airway mucus glands and excess secretion of mucus while empyema results from the destruction of the avar walls which creates resistance to expiratory flow this of course causes an increase in ATP utilization because of the use of accessory muscles for the patient to breathe the primary function of the respiratory system is to facilitate the exchange of gases at the pulmonary capillary membrane enabling respiration respiration involves several key physiologic processes diffusion as discussed earlier is the movement of gases from an area of higher concentration to an area of lower concentration and occurs at the Alvar capillary interface this allows oxygen to dissolve in the blood and for carbon dioxide to be expelled oxygenated blood is then transported from the lungs to the left side of the heart where it is pumped through the systemic circulation to supply organs and tissues the presence of numerous Alvi in the lungs provides an extensive surface area for gas exchange enhancing the efficiency of oxygen and carbon dioxide transfer this large surface area combined with the thin alv and capillary walls facilitates rapid diffusion and effective respiration ensuring that the body's tissues receive adequate oxygen for metabolic activities and that carbon dioxide which is a metabolic waste product is efficiently removed here we have a figure that shows oxygen exchange occurring in the capillaries of the lungs oxygen passes from the blood to the tissue cells and carbon dioxide and waste pass from the tissue cells to the blood",
        "Chemical Control of Breathing": "the chemical control of breathing is primarily managed by the respiratory center located in the brain stem which Reg Ates the rate and depth of respiration the primary stimulus for breathing is the accumulation of carbon dioxide in the blood elevated levels of carbon dioxide increase the acidity of the blood lowering its pH and this condition is known as primary respiratory acidosis conversely excessive exhalation of CO2 reduces the blood's CO2 retention raising its pH and leading to primary respiratory alkalosis low blood oxygen levels also act as a stimulus for breathing particularly through peripheral chemo receptors that detect decreases in oxygen levels and Signal the respiratory Center to increase ventilation changes in the partial pressure of carbon dioxide or pac2 can also occur as a compensatory mechanism in response to primary metabolic disturbances helping to maintain acidbase balance in the body Additionally the body has a backup system for controlling respiration known as the hypoxic drive this mechanism becomes more significant when oxygen levels are chronically low such as in certain respiratory diseases which prompts the body to rely on oxygen levels rather than CO2 levels to regulate breathing the interplay between these chemical signals ensures the precise regulation of breathing to meet the body's metabolic demands and maintain homeostasis",
        "Acid-Base Balance": "acidbase balance is a crucial aspect of maintaining homeostasis in the body an acid is a substance that increases the concentration of hydrogen ions in an aquous solution which leads to a decrease in PH conversely a base is a substance that decreases the concentration of hydrogen ions which result in an increase in PH the pH scale is the most common way to express acidity or alkalinity with lower pH values indicating higher acidity and higher pH values indicating higher alkalinity when the pH of the blood is elevated the condition is referred to as alkalosis indicating that the blood is too basic on the other hand when the pH of the blood is lowered the condition is called acidosis indicating that the blood is too acidic the body employs various mechanisms to regulate PH including buffering systems respiratory control of CO2 levels and renal regulation of bicarbon and hydrogen ions maintaining the appropriate acid base balance is vital for normal cellular function in the overall metabolic processes buffer systems are critical in maintaining the body's acid base balance by neutralizing excess acids or bases a buffer is a compound that can stabilize pH by absorbing hydrogen ions when they are in excess and donating hydrogen ions when they are depleted this ability allows buffers to minimize fluctuations in PH and maintain homeostasis in biological systems major buffers include bicarbonate phosphate and protein buffer systems the bicarbonate buffer system for instance involves a dynamic equilibrium between carbonic acid and bicarbonate ions when the concentration of hydrogen ions increases bicarbonate ions absorb them to form carbonic acid which then reduces acidity conversely when hydrogen ion concentration decreases carbonic acid dissociates the release of hydrogen ions which increases acidity buffer systems are essential to preventing drastic changes in PH that could disrupt cellular functions in metabolic processes this ensures that the body's internal environment remains stable despite external changes",
        "Ion Shifts and Buffer Systems": "ion shifts play a significant role in maintaining acid base balance within the body the concentration of hydrogen ions can be increased by directly adding more hydrogen ions to a solution or by removing hydroxide ions as these ions neutralize each other to make a solution more acidic an increase in hydrogen concentration and a decrease in hydroxide ions concentration are required conversely to make a solution more basic which means increasing the pH level one can either decrease the amount of hydrogen or increase the amount of hydroxide acids are classified as strong or weak based on their disassociation in water strong acids dissociate completely releasing more hydrogen ions whereas weak acids only partially dissociate proper acidbase balance is essential for cellular function it must be maintained using both sides of the cell membrane this balance is influenced by the movement of ions such as calcium and hydrogen for example an influx of hydrogen ions into the extracellular fluid can cause calcium ions to shift out of the cell contributing to acidosis conversely a decrease in extracellular hydrogen can lead to alkalosis there are three main components to the buffer system in the body the circulating bicarbonate buffer component holds and neutralizes excess acid it's found in both the intracellular and extracellular fluid and is the fastest acting segment of the buffer system carbonic acid is a weak acid and can give up extra hydrogen ions to reform as the bicarbonate ion the extra hydrogen ion is then converted into compounds that are easily expelled from the body El eliminating the extra acid another component is the respiratory drive the fastest way the body can get rid of excess hydrogen ions is to create water and carbon dioxide which can then be expelled as gases from the lungs lastly we have the renal component kidneys maintain homeostasis by retaining certain products and filtering out others it could take hours to days to restore the body's normal pH utilizing the renal component however it does a good job of controlling the increasing acid level in the blood by excreting the acid directly",
        "Medulla Oblongata and Ventilation": "the medulla oblongata is primarily responsible for initiating the ventilation cycle and is also primarily stimulated by high carbon dioxide levels the medulla has two main portions that control breathing the dorsal respiratory group and the vental respiratory group The drg is the main pacemaker for breathing and is responsible for initiating inspiration while the vrg helps facilitate forced inspiration or expiration as needed the pneumotoxic or pontine Center is located in the superior portion of the ponds and it helps shut off the Dr G resulting in shorter faster respirations the apneustic center which is located in the inferior portion of the ponds stimulates the drg resulting in longer slower respirations the Herring Brower reflex stops the vrg pneumotaxic center and apneustic centers from accidentally causing lung trauma by stopping the inhalation of gas",
        "Lung Volumes and Capacities": "lung volumes are critical measurements in respiratory physiology providing insights into the functionality and capacity of the lungs tital volume refers to the amount of air that is inhaled or exhaled during a single normal breath this volume varies depending on the individual's age size in physical condition but it typically averages about 500 millit in a healthy adult inspiratory Reserve volume or Irv is an additional amount of air that can be inhaled with maximum effort after a normal tidal inhalation this volume represents the reserve capacity of the lungs to take in extra air beyond the typical tital volume which which can be especially important during physical exertion or in situations requiring increased oxygen intake the Irv is typically about 3,000 milliliters in healthy adults but it can vary based on factors such as lung compliance muscle strength and overall health expiratory Reserve volume or Erv refers to the maximum amount of air that can be forcefully exhaled after the completion of a normal quiet exhalation this volume represents the additional capacity of the lungs to expel air beyond the regular tital volume and it's an important measure in evaluating respiratory function and strength typically Erv is about 1200 milliliters in healthy adults although this can vary based on factors such as age gender and physical condition residual volume or RV is the amount of air that remains in the lungs after a maximal exhalation ensuring that the lungs stay open and Alvi do not collapse this volume cannot be voluntarily expelled and serves to maintain lung structure and facilitate continuous gas exchange between breaths residual volume is generally around 1200 mlit in adults vital capacity or VC is a total volume of air that can be moved in and out of the lungs during maximum inspiration and expiration it encompasses title volume inspiratory Reserve volume and expiratory Reserve volume vital capacity is a key indicator of lung health and overall respiratory capacity and is often measured using spirometry tests in adults vital capacity typically ranges from 4 to 5,000 milliliters depending on factors such as height age and sex Dead Space refers to the portion of the respiratory system where gas exchange does not occur because there's no Alvi this includes the Airways such as the trachea bronchi and bronchioles where air is conducted but not exchanged with the blood dead space is divided into anatomical Dead Space which consists of the conducting Airways physiological Dead Space which includes both anatomical dead space and any Alvi that are not profused with blood and thus do not participate in gas exchange the depth of each breath known as tidal volume is critical for assessing ventilation tital volume indicat indic Ates how much air is moved into and out of the lungs with each respiratory cycle and it is essential for evaluating lung function and ensuring adequate ventilation and oxygenation abnormalities in tidal volume can indicate respiratory distress restrictive lung diseases or other pulmonary conditions minute volume or minute ventilation is the total volume of air that moves in and out of the lungs in one a minute it is calculated by multiplying the tital volume by the respiratory rate minute volume provides a comprehensive measure of pulmonary ventilation efficiency helping to assess whether the respiratory system is meeting the body's metabolic demands normal breathing is characterized by regular rate and depth it follows a consistent Rhythm or pattern of inhalation exhalation indicating that the respiratory control centers are functioning properly normal breathing also includes clear and audible breath sounds on both sides of the chest signifying unobstructed Airways and effective lung ventilation there should also be a symmetrical rise and fall of the chest during breathing reflecting balanced long inflation movement of the abdomen is also a normal feature as diaphragmatic breathing allows the contraction and relaxation of the diaphragm contributing to efficient ventilation and oxygenation of the blood",
        "Circulatory System Overview": "the circulatory system also referred to as the cardiovascular system is a complex network of tubes comprising arteries veins and capillaries that are connected to the heart which acts as a pump this system is entirely closed meaning that the blood remains within the network of vessels at all times as it circulates throughout the body the circulatory system is divided into two primary circuits the systemic circulation and pulmonary circulation systemic circulation is responsible for transporting oxygenated blood from the left side of the heart to the tissues and organs of the body and then returning deoxygenated blood back to the right side of the heart pulmonary circulation carries deoxygenated blood from the right side of the heart to the lungs where it is oxygenated before being returned to the left side of the heart this dual circuit Arrangement ensures that oxygen-rich blood is delivered to the body's tissues while carbon dioxide and other waste products are removed efficiently here we see the circulatory system including the heart arteries veins and interconnecting capillaries the heart is a muscular organ that pumps blood throughout the body it is located directly behind the sternum and is about the size of a closed fist approximately 2/3 of the heart lies in the left part of the media stum heart muscle is called myocardium pericardium which is the paracardial sac is a thick fibrous membrane that surrounds the heart and the bases of the great vessels the visceral layer of the pericardium lies closely against the heart and is also called the epicardium the second layer of the pericardium is separated from the visceral layer by a small amount of paracardial fluid that reduces friction within the pericardial Sac the endocardium is the interior lining of the heart with the epicardium being the outside lining the interatrial septum separates the two atria while the intraventricular septum separates the right and left ventricles each Atrium receives blood that is returned to the heart from other parts of the body while each ventricle in turn pumps blood out of the heart semi lunar valves are located between the ventricles and the arteries into which they pump blood blood enters the right atrium via the superior and inferior vnea and the coronary sinus blood from four pulmonary veins enters into the left atrium between the right and left Atria is a depression the foso ovalis this represents the former location of the fireman ovil which was the ovil that was opened and bypassed the lungs when the patient was in utero blood passing from the Atria to the ventricles flows through one of two atrio ventricular valves the tricuspid valve separates the right Atria from the right ventricle and the mitro valve separates the left Atria from the left ventricle the valves consists of flaps called cusps papillary muscles attached to the ventricles and send small muscular strands called cord tendon to the cusps two semilunar valves the aortic valve and pulmonic valve divide the heart from the aorta and the pulmonary artery the pulmonic valve regulates blood flow from the right ventricle to the pulmonary artery while the aortic valve regulates blood flow from the left ventricle to the aorta superior vena and the inferior vena return deoxygenated blood from the body to the right atrium freshly oxygenated blood is returned to the left atrium through the pulmonary veins blood then flows through the mitro valve into the left ventricle which pumps the oxygenated blood through the aortic valve into the a a and then to the entire body it's important to remember that the left ventricle is the strongest and largest of the four cardiac Chambers this is because it must pump against the afterload in order to move blood through systemic circulation heart sounds are created by the contraction and relaxation of the heart and the flow of blood they can be heard during o exultation with a stethoscope love is the first heart sound or S1 and dub is the second heart sound or S2 S3 and S4 are not usually heard in people with normal heart function for other sounds all abnormal may be heard when oscilating the heart in Greater vessels a murmur is an abnormal whooshing sound heard over the heart and indicates turbulent blood flow throughout the heart a brwy is an abnormal wooing sound heard over the main vessel that indicates turbulent blood flow within the blood vessel both clicks and snaps indicate abnormal cardiac valve function",
        "Heart's Electrical Conduction System": "the electrical conduction system of the heart is responsible for coordinating the mechanical pumping action in response to electrical stimuli this system ensures that the heart contracts efficiently to pump blood throughout the body the brain through the autonomic nervous system partially regulates the heart's rate and the strength of its contractions by sending signals that either accelerate or decelerate the heartbeat based on the body's needs the regulation of heart function involves a complex interplay of various physiological mechanisms that are primarily controlled by the autonomic nervous system the heart's chronotropic rate or rate of the heartbeat dromotropic State or the speed of electrical conduction and inotropic state force of contraction are regulated by signals from the brain Barrow receptors which are Loc located in the heart and Main arteries respond to changes in blood pressure while chemo receptors detect variations in the chemical composition of the blood such as oxygen and carbon dioxide levels the stimulation of these receptors can activate either the parasympathetic or sympathetic branches of the autonomic nervous system parasympathetic activation generally slows the heart rate and reduces the force of contraction while sympathetic activation increases both heart rate and contractility Alpha receptors when stimulated cause Vaso constriction which increases blood pressure beta receptors on the other hand enhance inotropic dromotropic and chronotropic responses this increases the heart's output and efficiency the SA node which is located in the right atrium is the primary p maker of the heart indicating electrical impulses that set the Rhythm for heartbeats these impulses then travel to the atrio ventricular node where they are delayed slightly to allow the Atria to contract and fill the ventricles with blood from The Av node the electrical signal moves through the bundle of hiss which divides into the right and left bundle branches conducting the impulses through the intraventricular septum finally the signal reaches the peni fibers which distribute the electrical stimulus throughout the ventricles causing them to contract and pump blood to the lungs and the rest of the body the regulation of heart function involves a complex interplay between the heart and the autonomic nervous system which modulates the hearts chronotropic dromotropic and inotropic states Bearer receptors which again are located primarily in the heart and the main arteries monitor changes in blood pressure and relay this information to the brain while chemo receptors detect variations in the chemical composition of the blood when these receptors are stimulated they activate either the parasympathetic or sympathetic branches of the autonomic nervous system leading to adjustments in the heart's rate and contractility the sympathetic nerv system through beta adrenic receptors increase the heart rate conduction velocity and contractile Force which then enhances cardiac output we refer to this as the beta effect conversely the parasympathetic nervous system primarily to the vagus nerve can decrease heart rate and reduce the force of contractions Alpha aeric receptor stimulation leads to Vaso constriction which increases peripheral vascular resistance and blood pressure these regulatory mechanisms ensure the heart responds appropriately to the body's varying physiological demands maintaining adequate blood flow and pressure",
        "Cardiac Cycle and Hemodynamics": "the cardiac cycle is the sequence of events that occur in the heart from the beginning of one heartbeat to the start of the next resulting in the pumping action of the heart it comprises two main phases syy and diast syy is the phase during which the ventricular Mass contracts forcing blood into the systemic circulation through the aorta and pulmonary arteries ensuring the delivery of oxygenated blood to the body and deoxygenated blood to the lungs diast is the relaxation phase during which the ventricles filled with blood from the Atria preparing for the next contraction pulse pressure is defined as the numerical difference between the systolic and diastolic pressures it is an important indicator of the health and functionality of the cardiovascular system a normal pulse pressure reflects adequate ventricular function and arterial compliance while abnormalities and pulse pressure indicate serious cardiac or vascular conditions after load refers to the resistance that the left ventricle must overcome to eject blood into the aorta during syy this resistance is primarily determined by the pressure in the aorta and the systemic circulation when after load increases it becomes more difficult for the left ventricle to pump blood effectively leading to a reduction in stroke volume which is the amount of blood ejected with each heartbeat higher afterload requires the heart to work harder potentially leading to hypertrophy and decreased cardiac efficiency over time cardiac output is a critical measure of heart function and represents the total volume of blood that is pumped by the heart through the circulatory system in 1 minute it is calculated by multiplying the stroke volume by the heart rate cardiac output is an important determine perent of the oxygen and nutrient delivery to tissues and organs and is essential for maintaining adequate profusion throughout the body understanding the Dynamics of after load and its impact on stroke volume and cardiac output is essential for diagnosing and managing various cardiovascular conditions the Starling law of the heart indicates that an increase in Venus return to the heart stretches the ventricular walls which result in an increased force of contraction this mechanism ensures that the heart pumps out all of the blood that returns to it thus maintaining a balance between the input and output of blood the greater the stretch of the ventricular muscle fiber the stronger the contraction which increases cardiac output ejection fraction is a measurement used to assess the efficiency of the heart's pumping action it represents the percentage of blood that is ejected from the left ventricle with each contraction relative to the total amount of blood in the ventricle at the end of diast a normal ejection fraction ranges from 55 to 70% and lower values typically indicate heart failure or other severe cardiac conditions preload prefers to the initial stretching of the cardiac myocytes prior to contraction this is related to the pressure under which The ventricle fills it is influenced by the volume of Venus blood returning to the heart and the compliance of the ventricular walls preload is the key determinant of stroke volume as it affects the IND diastolic volume which in turn influen uences the force of contraction according to the Frank Starling mechanism proper preload ensures adequate ventricular filling and optimal cardiac output",
        "Vascular System": "the vascular system is a complex Network responsible for the transport of blood throughout the body and is comprised of arteries veins and capillaries arteries which carry oxygenated blood away from the heart Branch into progressively smaller vessels called arterioles these arterioles further divide into capillaries which are the smallest vessels and which facilitate the exchange of oxygen nutrients and waste products between the blood and tissues after passing through the capillary beds deoxygenated blood is collected into vinals which coales into larger veins that return to the heart the walls of blood vessels are composed of three layers of tissue the smooth thin in lining known as the tuna intima or endothelium the middle layer known as the Tunica Media which is composed of elastic tissue and smooth muscle cells and the outer layer of tissue known as the tuna aventia which consists of elastic IC and fibrous connective tissue circulation to the heart is primarily supplied via the coronary arteries which branch from the base of the aorta these arteries emanate from the left and right coronary arteries ensuring that the heart receives a continuous supply of oxygenated blood the right coronary artery further divides into nine important branches supplying blood to various parts of the heart including the right atrium right ventricle and portions of the left ventricle and interventricular septum the left bang coronary artery is the largest and shortest of the myocardial blood vessels and quickly bifurcates into two significant branches the left anterior descending or L artery which supplies the anterior portion of the interventricular septum and the anterior walls of the left ventricle and the circle Flex coronary artery which provides blood to the lateral and posterior aspects of the left ventricle this figure shows the two main coronary arteries that Supply The myocardium with blood",
        "Pulmonary and Systemic Circulation": "pulmonary circulation is the process by which blood is transported from the right side of the heart heart to the lungs and back to the left side of the heart this system begins with deoxygenated blood from the right ventricle being pumped through the pulmonic valve into the pulmonary artery the pulmonary artery carries the De oxidated Blood to the lungs where gas exchange occurs in the alv allowing carbon dioxide to be expelled and oxygen to be absorbed into the blood the now oxygenated blood flows to the pulmonary veins and returns to the left atrium of the heart from the left atrium the blood moves into the left ventricle from where it's pumped into the systemic circulation to supply the body's tissue with oxygen and nutrients systemic arterial circulation begins as oxygenated blood leaves the heart through the aortic valve and passes into the aorta the ascending aort arises from the left vcal and consists of only two branches the right and left coronary arteries the three major arteries arise from the aortic Arch these are the brachio calic or enoma artery the left common cored artery and the left subclavian artery the descending aorta is the longest portion of the aorta and is subdivided into the thoracic aorta and abdominal aorta this figure shows the principal arteries and veins",
        "Vascular Supply to Head and Neck": "the vascular supply to the head and neck involves key arterial branches that originate from the aortic Arch the brachio falic artery is the first major vessel to branch from the aortic Arch and IT Supplies blood to the right side of the head and neck as well as the right arm each common cored artery ascends along the neck and at the level of the angle of the mandible it then bifurcates into the internal and external kateed arteries this point of division is known as the kateed bation the internal cored artery continues to supply blood to the brain while the external cored artery provides blood to the face scalp and neck structures this bip forcation is a critical anatomical landmark in the vascular anatomy of the head and neck",
        "Vascular Supply to Upper Extremity": "the vascular supply to the upper extremity begins with the subclavian artery which provides blood to the brain neck anterior chest wall and shoulder as the subclavian artery travels laterally and reaches the shoulder joint joint it transitions into the axillary artery the axillary artery continues through the axilla or armpit region and supplies blood to the shoulder and upper arm below the head of the humoris the axillary artery becomes the brachial artery which runs down the upper arm and is the main blood supply to the arm muscles and other tissues this arterial pathway ensures a continuous and adequate blood supply to the upper extremity",
        "Thoracic and Abdominal Aorta": "the thoracic aorta is made up of the visceral arteries and the parial arteries visceral arteries Supply blood to the thoracic organs while parial arteries Supply blood to the thoracic wall intercostal arteries Branch into anterior and posterior intercostal arteries while the anterior intercostal arteries originate as branches of the subclavian system the posterior intercostal arteries arise directly from the aorta the abdominal aorta is divided into visceral and parietal portions the visceral arteries are subdivided into paired and non-paired arteries the unpaired branches include the Celiac trunk Superior mesenteric and inferior mesenteric arteries the Celiac trunk supplies blood to the esophagus stomach dadum spleen liver and pancreas the superior mesenteric artery supplies blood to the pancreas small intestine and colon the inferior mesenteric artery supplies blood to the descending colon and rectum paired branches of the visceral abdominal aorta Supply blood to the kidneys adrenal glands and gonads",
        "Vascular Supply to Pelvis and Lower Extremity": "the vascular supply to the pelvis and lower extremity begins at the level of the fifth lumbar vertebrae where the aorta divides into the two common iliac arteries the external iliac arteries which are branches of the common iliac arteries continue into the thigh and become the femoral arteries as the femoral artery descends through the lower thigh it transitions into the pole artery which supplies blood to the knee region in the lower leg the anterior tibial artery continues down the foot where it becomes the dorsalis Pettis artery providing blood to the dorsal aspect of the foot the plantar arteries which Supply the sole of the foot arise from the posterior Tio artery",
        "Venous System": "the two major veins of the head and neck are the external and internal jugular veins the spaces between the membranes that surround the brain form Venus sinuses the external and interior jugular veins join the subclavian veins that feed these Venus sinuses Venus drainage begins at the anterior and posterior intercostal veins and provides the major source of flow into the superior vena all Venus drainage from the lower part of the body body passes through the inferior vnea internal iliac veins drain the pelvis and the external iliac veins drain the lower limbs the aaic pornal vein is a specialized part of the Venus system that drains blood from the liver stomach intestines and spleen blood then empties into the hepatic veins which join the inferior vnea the veins of the upper extremity vary somewhat from person to person but typically in the upper forearm these veins combin to form the Basilica vein and the calic vein the basilic and calic veins combin to form the axillary vein the longest vein in the body is the great sapineus vein the sapineus vein originates over the dorsal and medial side of the foot and ascends along on the medial side of the leg and thigh emptying into the femoral vein the veins of the feet also drain into the anterior and posterior tibial veins which accompany their respective arteries and unite at the knee to form the poal vein",
        "Blood Composition and Function": "blood is composed of plasma and formed elements with plasma making up 55% and formed elements including red blood cells white blood cells and platelets accounting for the remaining 45% plasma is a watery straw colored fluid that constitutes more than half of the total blood volume it's composed of 92% water and 8% dissolved substances such as proteins electrolytes and nutrients within plasma proteins play a vital role in maintaining ontic pressure and serving as carriers for various substances oxygen and carbon dioxide are dissolved in plasma and are crucial for Respiratory function while nitrogen is present in smaller amounts nutrients are transported to cells throughout the body and cellular wastes are carried away for excretion other components that they collectively only make up about 1% of plasma include a variety of essential molecules that are necessary for day-to-day physiological function also known as arthy red blood cells are essential for transporting oxygen and tissues throughout the body they achieve this through hemoglobin A protein that binds oxygen and imparts the red color to the cell EOP poesis is the continuous process of RBC production ensuring the body maintain sufficient oxygen carrying capacity when rbcs reach the end of their life band they decompose in the spleen and other maccrage Rich tissues hemoglobin is partly recycled with the non-recyclable portion converted into B Rubin white blood cells or lucaites are crucial for the immune response they are motile and exit blood vessels via diapedesis to reach infection or injury sites white blood cells are categorized into granasy and a granites granulites including neutrophils asops and basophils contain large cytoplasmic granules that are visible under a light microscope neutrophils are the most common granulocytes while ails stain bright red with aosen and basophils the least common contain histamine and Hein a granulocytes which lat granules include lymphocytes and monocytes monocytes differentiate into micras key players in inflammation platelets or thrombocytes are small blood cells that are essential for clot formation upon vascular injury a series of events known as hemostasis are triggered tissue thromboplastin for damaged tissue activates a clotting Cascade which leads to a thrombin formation thrombin converts fibrogen into fibron forming a mesh that stabilizes the clot the fibr linic system which involves tissue plasmagen activator or TPA ensures clot breakdown by converting plasmagen into plasman maintaining vascular Health the and RH blood groups are fundamental to blood transfusion compatibility and immunological responses rbcs have surface antigens that are key to identifying blood types antigens are molecules that when introduced into the body triggered the immune response to produce specific protective proteins known as antibodies the blood group system classifies blood into four main types based on the presence or absence of A and B antigens on the surface of rbcs type O blood which lacks both A and B antigens is known as the universal donor as it can be transfused to individuals of any type conversely AB blood which has both A and B antigens is termed the universal recipient because individuals with this blood type can re receive blood from any group Additionally the RH blood group system includes the Rh factor an antigen that can either be present RH positive or absent Rh negative the presence or absence of the Rh factor is critical in blood transfusions as it must be matched to prevent immune reactions",
        "Pulse and Blood Pressure": "the physiology of the circulatory system involves the generation of the pulse and measurement of blood pressure the pulse is generated when blood is pumped from the left ventricle into the major arteries creating a wave of pressure that can be palpated most easily at locations such as the neck wrist or groin central pulses including the cored andoral pulses provide critical information about the blood flow to vital organs while peripheral pulses such as the radial brachial posterior tibial and dorsalis Pettis pulses give insights into the blood flow to the extremities blood pressure which is defined as the force exerted by Blood against the walls of arteries is a key indicator of cardiovascular health systemic vascular resistance or svr refers to the degree of dilation or constriction of blood vessels excluding the pulmonary vessels it is a measure of the resistance to blood flow Within These vessels the diameter of the blood vessels plays a role in svr as constricted vessels increase resistance and dilated vessels decrease resistance this relationship is particularly significant in the context of shock where changes in vessel size can affect blood pressure and tissue profusion on average an adult has approximately 5 lers of blood circulating through their body whereas children have approximately 2 to 3 meters infants have only about 300 milliliters about the approximate size of a canos soda normal circulation in adults involves the automatic adjustment and Readjustment of the circulatory system to maintain adequate blood flow throughout the body profusion refers to the sufficient circulation of blood within an organ or tissue to meet its metabolic needs when normal blood pressure is lost it indicates that blood is no longer being efficiently circulated to all organs potentially compromising their function shock is a critical condition that is characterized by inadequate circulation and profusion of the entire body this leads to insufficient oxygen and nutrient delivery to organs and tissues inadequate circulation in adults occurs when the body responds to a decrease in blood volume such as from Hemorrhage the heart automatically adjusts by attempting to maintain blood pressure despite the reduced volume blood vessels con strict to create a smaller circulatory bed which helps to maintain pressure and ensure that the remaining blood is distributed more effectively to compensate the heart rate increases pumping more rapidly to circulate the available blood this increase in pulse rate occurs as blood pressure Falls however if the blood loss is severe and exceeds the body's compensatory mechanisms these adjustments will fail leading to a State of Shock the function of blood in the body in involves its uneven distribution where approximately 30% of the blood is located within the heart arteries and capillaries which are responsible for transporting oxygenated blood from the heart to tissues and returning deoxygenated blood to the heart the remaining 70% of the blood is found within the veins and venules which serve as reservoirs and conduits for the return of blood to the heart this distribution is needed for maintaining adequate profusion and oxygen delivery to various organs and tissues the interstial space which is the area between cells play a vital role in fluid exchange and nutrient transport within the capillaries two main forces hydrostatic pressure and oncotic pressure govern the movement of fluids hydrostatic pressure which is exerted by Blood against the capillary walls pushes fluid out of the capillaries and into the interstitial space on the Venus side of the capillary this pressure significantly diminishes allowing oncotic pressure which is generated by plasma proteins to draw fluid back into the capillaries coagulation or clotting is a critical process that's initiated when a blood vessel is injured which leads to a c Cascade of chemical reactions that produce fibrin fibers which then trap red blood cells forming a clot to prevent excessive bleeding",
        "Lymphatic System": "the lymphatic system is responsible for the passive circulation of lymph which is a thin plasma-like fluid that's derived from interstitial fluid or extracellular fluid this lymph is transported throughout the body via thin walled lymph vessels as lymph travels through these vessels Farm materials are filtered out of the lymph nodes this filtered lymph is then returned to the main circulatory system through the thoracic duck this helps maintain fluid balance which protects the body against infections and facilitates the removal of cellular waste lymphatic vessels function to transport fluid away from tissues ensuring the removal of excess interstitial fluid and its return to the bloodstream these vessels are part of a network that includes lymphatic capillaries which are distributed throughout nearly all tissues of the body however lymphatic capillaries are absent in specific areas such as the central nervous system bone marrow cartilage epidermis and your cornea",
        "Nervous System Overview": "the nervous system is the most complex organ system within the human body consisting of the brain spinal cord and an extensive network of nerves it's divided into two main components the central nervous system and the peripheral nervous system the CNS includes the brain and spinal cord serving as the control center for the body with the brain being the center of Consciousness the brain itself has three major divisions the cerebrum which is responsible for the higher cognitive functions the cerebellum which coordinates movement and balance and the brain stem which controls vital involuntary functions the peripheral nervous system is further divided into the sematic nervous system which regulates involuntary activities such as walking and talking in the autonomic nervous system which manages our involuntary functions such as heart rate and digestion the cerebrum which is the largest part of the brain is commonly referred to as the gray matter due to its color and composition it's divided into four main distinct loes the frontal parietal temporal and occipital loes each lobe has specific functions such as higher cognitive functions in the frontal lobe sensory information processing in the parietal lobe auditory processing in the temporal lobe and visual processing in the occipital lobe neurons in the cerebrum generate electrical impulses that travel along nerve fibers which extend from each cell and communicate with the spinal cord this facilitates the transmission of signals that control various bodily functions and responses the cerebellum which is often referred to as the athletes brain plays a pivotal role in coordinating the various activities of the body particularly those involving our body movements this region ensures smooth balanced and precise actions by integrating input from different sensory systems and find tuning motor activities it receives signals from the spinal cord and other parts of the brain to manage posture equilibrium and muscle tone making it essential for comp Lex voluntary movements the brain stem which is recognized as the most primitive part of the CNS lies deep within the cranium providing it with robust protection this vital structure comprises three primary regions the midbrain ponds and medulla oblongata the brain stem controls fundamental life support functions such as heart rate breathing and blood pressure regulation ensuring the body's basic needs are met for survival additionally it serves as a conduit for all of the information transmitted between the brain and spinal cord within the brain stem the reticular activating system or Ras in the midbrain is particularly noteworthy as it plays a crucial role in maintaining Consciousness and alertness the RAS filters incoming stimuli and determines which sensory organs reach the conscious mind thereby regulating weightfull transitions the pond serves as a Communication Center between different parts of the brain while the medulla oblongata manages autonomic functions like respiratory Rhythm and reflexive actions such as swallowing and coughing collectively the brain stems regions work in concert to control and regulate vital body functions underscoring the significance in overall CNS function",
        "Spinal Cord and Meninges": "the spinal cord which is an extension of the brain stem is a critical component of the central nervous system it contains nerve cell bodies and nerve fibers that transmit information to and from the brain this transmission occurs via a complex network of ascending and descending pathways the principal function of the spinal cord is to serve as a conduit for messages between the brain and the body facilitating the communication necessary for motor and sensory functions through this network sensory information from the peripheral nervous system is relay to the brain while motor commands from the brain are sent to the body's muscles and organs this bidirectional flow of information is crucial for coordinating involuntary movements reflex actions a maintaining overall bodily homeostasis the meninges are a set of three protective membranes that enclose the entire central nervous system these layers are the Duram matter arachnoid matter and patter the Duram matter is the tough outermost layer providing the primary protective barrier the it lies the arachnoid matter which is the middle layer the innermost layer is the Pia matter which adheres closely to the surface of the brain in spinal cord these membranes float in cerebral spinal fluid or CSF which is a clear fluid that's produced by the choid plexus in the brain's ventricles the CSF cushions the brain the spinal cord circulates nutrients and removes waste products it flows freely within the subarachnoid space which again is the area between the arachnoid matter and the Pia and ensures that the CNS is well protected and maintains its physiological environment",
        "Diencephalon and Limbic System": "the Deyon which is situated between the brain stem and cerebrum encompasses the thalmus subthalamus hypothalmus and the epithalamus the thalmus is responsible for processing most sensory inputs and plays a role in influencing mood and general body movements the hypothalamus which is located just below the thalmus regulates numerous body functions including temperature control hunger thirst and Arcadian rhythms the integration and regulation of autonomic functions emotional responses and hormone releases are also managed by the hypothalamus making it a critical component in maintaining homeostasis within the body the lyic system which is often referred to as the emotional brain is a complex set of structures located deep within the brain that plays a role in regulating emotions motivation mood and sensations of pain and pleasure it includes key components such as the amydala hippocam campus thalmus and hypothalmus the amydala is involved in processing emotions such as fear and pleasure while the hippocampus is essential for forming new memories and connecting emotions to these memories the thalmus acts as a relay station for sensory information and the hypothalmus regulates autonomic functions and emotional responses together these structures influence our emotional state drive our motivations and me mediate our responses to pain and pleasure thereby providing a significant role in our overall mental and emotional well-being",
        "Limbic System and Emotional Processing": "the lyic system which is often referred to as the emotional brain is a complex set of structures located deep within the brain that plays a role in regulating emotions motivation mood and sensations of pain and pleasure it includes key components such as the amydala hippocam campus thalmus and hypothalmus the amydala is involved in processing emotions such as fear and pleasure while the hippocampus is essential for forming new memories and connecting emotions to these memories the thalmus acts as a relay station for sensory information and the hypothalmus regulates autonomic functions and emotional responses together these structures influence our emotional state drive our motivations and me mediate our responses to pain and pleasure thereby providing a significant role in our overall mental and emotional well-being",
        "Peripheral Nervous System Overview": "the peripheral nervous system or pns is composed of bundles of nerve fibers or axons that connect the central nervous system to the rest of the body it's divided into two main parts the sematic and autonomic nervous system as stated earlier the sematic nervous system transmits signals from the brain to the voluntary muscles controlling movements such as walking and talking the autonomic nervous system is further subdivided into the sympathetic and parasympathetic nervous systems the sympathetic nervous system is responsible for the fight ORF flight response which prepares the body to respond to perceived threats by increasing heart rate dilating Airways and other phys iological changes in contrast the parasympathetic nervous system generally promotes a rest and digest State slowing down bodily functions to conserve energy",
        "Sensory and Motor Nerves": "within the pns there are two types of nerves sensory nerves and motor nerves sensory nerves carry information from the body to the CNS they include special sens nerves that detect heat cold position motion pressure pain balance light taste and smell when sensory nerve endings in the extremities are stimulated these impulses are transmitted along peripheral nerves to the spinal cord motor nerves on the other hand carry information from the CNS to the muscles of the body electrical impulses that are generated by the cell body in the spinal cord travel along motor nerves to the muscles causing them to contract and produce movement this intricate network of sensory and motor pathways allows the pns to facilitate communication between the CNS and the body's muscles and sensory receptors",
        "Spinal Reflexes and Cranial Nerves": "spinal reflexes are rapid automat aut atic responses to stimuli that involve short fibers connecting sensory nerves with motor nerves thereby creating direct connections that bypass the brain when an irritating stimulus is detected by a sensory nerve the signal is transmitted directly from the sensory nerve along the connecting nerve to the motor nerve which results in a quick involuntary response the cranial nerves consist of 12 pairs that arise from the base of the brain each passing through a fan in the skull to reach its specific endpoint these nerves serve various functions the olfactory nerve is responsible for the sense of smell the optic nerve facilitates Vision the ocular motor nerve inates the muscles that control the movement of the eyeballs and upper lid the tro clear nerve innervates the superior opiak muscle of the eyeball the trigeminal nerve supplies sensation to the scalp forehead face and lower jaw through its opic maxillary and mandibular divisions the abducens nerve controls the lateral movement of the eyeball through the lateral rectus muscle the facial nerve controls the muscles of facial expression provides the sense of taste to the anterior 2/3 of the tongue and offers cutaneous sensation to the external ear tongue and pallet the vestibulo clear nerve is responsible for hearing IM balance passing through the internal auditory meus the glassop farango nerve supplies motor fibers to the Fingal muscles the vagus nerve provides motor functions to the soft pallet ferx and Linex which contributes to voice production the spinal acccessory nerve inates the muscles of the soft pallet ferx sternomastoid and trapezius muscles which helps in swallowing speech as well as Head and Shoulder movements lastly the hypoglossal nerve controls the muscles of the tongue and throat these cranial nerves are integral to various sensory motor functions as you progress in your careers in advanced life support neurological assessment will almost certainly evaluate the functioning of the 12 cranial nerves on a regular basis",
        "Dermatomes and Nerve Mapping": "an often unutilized but extremely helpful physical diagnostic exam relates to dermatonics specific areas of the skin that are innervated by sensory fibers from Individual spinal nerves each spinal nerve corresponds to a particular region of the skin and this creates a map-like distribution as you can see on the figure here on the screen these dermatonics and understanding the effects of nerve damage or compression as symptoms such as pain numbness or tingling can be traced back to the affected spinal nerve dermatonics helps in effectively blocking specific nerves",
        "Structure and Function of the Eye": "the eyeball referred to as the globe is a complex organ responsible for vision the inner surface of the eyelids and in the exposed surface of the eye are covered by a delicate membrane known as the conjunctiva which is kept moist by fluid produced from the lacrimal glands this lubrication is essential for protecting the eye and maintaining Clear Vision located behind the iris is the lens which plays a role in focusing images onto the retina the light sensitive area at the back of the globe the retina contains numerous nerve endings that respond to light by transmitting nerve impulses through the optic nerve to the brain enabling the perception of visual images central vision which is facilitated by the central part of the retina allows for the clear visualization of objects directly in front of the Observer while the peripheral regions of the retina process peripheral vision which provides Ides a broader field of view",
        "Overview of the Integumentary System": "the integumentary system is the largest system in the human body it serves as the primary interface between the body and the external environment with the skin acting as a barrier that protects against pathogens mechanical injuries and harmful substances this complex organ plays a vital role in maintaining homeostasis the constancy of the internal environment by regulating temperature preventing dehydration through its waterproof barrier and enabling sensory perception through a network of nerve endings Additionally the skin synthesizes vitamin D upon exposure to sunlight which is essential for various body functions including calcium absorption the skin structure includes multiple layers such as the epidermis dermis hypodermis with each contributing to its protective and Regulatory functions the skin is divided into two main parts the epidermis and the dermis the epidermis is a superficial layer which is composed of several layers of cells and it serves as a body's first line of defense against environmental threats this layer varies in thickness on the soles of the feet back and scalp it's relatively thick whereas in others it is only two or three cell layers thick the outermost cells of the epidermis are continuously shed and replaced by new cells produced by the germinal layer at the base of the epidermis as these new cells migrate to the surface they die and form the Strat corneum below the epidermis lies the dermis a deeper and more resilient layer of connective tissue it's primarily composed of collagen fibers elastic fibers and mucco polysaccharide gel which contains fiber blasts that secrete collagen elastin and ground substance this layer also houses many specialized structures including sweat glands sebaceous glands hair follicles blood vessels lymph vessels and specialized nerve endings beneath the skin is the subcutaneous tissue layer which mainly consists of fat and below this is a dense fibrous layer known as the Deep fascia additionally orifices such as the mouth nose anus and vagina are lined with mucous membranes that like the skin provide a protective barrier against bacterial Invasion but do differ in their secretion of mucus"
    },
    {
        "Introduction to Pathophysiology": "chapter eight pathophysiology pathophysiology ology is the field of study that focuses on the physiological processes associated with disease or injury when the body fails to maintain homeostasis which is the stable internal environment necessary for optimal functioning disease can ensue this loss of homeostasis can result from various factors including genetic mutations environmental toxins or infections understanding the mechanisms by which diseases alter cellular structure and function is imperative disease processes can disrupt normal cell activities leading to changes in cell morphology impaired metabolic functions and alterations in signaling Pathways these cellular changes can ultimately affect tissue and organ function contributing to the clinical manifestations of disease therefore a thorough comprehension of these alterations is fundamental for diagnosing and treating pathological conditions.",
        "Cellular Adaptation Mechanisms": "when exposed to adverse conditions cells undergo a process of adaptation to maintain function and viability this adaptive process includes several distinct mechanisms atrophy is characterized by a decrease in cell size due to the loss of subcellular components often in response to reduce demand or adverse environmental conditions hypertrophy involves an increase in cell size which results from the synthesis of more subcellular components to meet increased functional demand hyperplasia refers to an increase in the number of cells within an organ or tissue which can occur as a response to increased physiological demands or pathological stimuli displasia involves alterations in the size shape and organization of cells which often indicates a pre-cancer state metaplasia is a reversible process where one adult cell type is replaced by another allowing the tissue to better withstand the adverse conditions each of these adaptations represents a cellular strategy that copes with stress and helps maintain tissue function.",
        "Fluid and Electrolyte Balance": "the human body is composed primarily of water making fluid balance vital for Main maintaining homeostasis disruptions in fluid and electrolyte balance can lead to or worsen various disease processes these disruptions may occur due to excessive fluid loss or intake impacting the body's ability to regulate its internal environment the degree to which fluid imbalance affects homeostasis and causes illness varies based on several factors including the patient's size age and underlying medical conditions proper fluid management is a key aspect of resuscitation efforts ensuring that the body's fluid levels are restored to maintain cellular function and overall health.",
        "Edema and Its Causes": "edema is a swelling caused by the accumulation of excessive fluid in body tissues it can arise from various causes including increased capillary hydrostatic pressure which can occur due to allergic reactions inflammation Venus obstruction pregnancy or heat stress another cause is decreased colloidal osmotic pressure in the capillaries often resulting from reduced production of plasma proteins in conditions like liver disease or severe protein deficiency or increased loss of plasma proteins due to kidney diseases or extensive Burns obstruction of lymphatic vessels can also lead to edema the clinical manifestations of Edema can be localized to a specific area or generalized throughout the body a thorough physical assessment is necessary to evaluate edema this includes oscilation of breath sounds to detect any pulmonary involvement evaluation of pedal and sac edema and checking for jugular Venus distension clinical signs should also be monitored to assess the overall health status of the patient the definitive treatment for edema depends greatly on addressing the underlying medical condition causing the fluid imbalance.",
        "Isotonic Fluid Imbalances": "isotonic fluid deficit refers to a decrease in extracellular fluid where the losses of sodium and water are proportional this type of fluid loss is the most common form of fluid imbalance it can occur due to various reasons such as gastrointestinal losses due to vomiting and diarrhea Hemorrhage or excessive sweating on the other hand isotonic fluid excess involves around a proportional increase in the levels of sodium and water in the extracellular fluid common causes of isotonic fluid excess include conditions such as kidney failure where the kidneys are unable to excrete enough sodium and water and heart failure where the heart's reduced pumping efficiency leads to fluid retention understanding these fluid imbalances is important in diagnosing and managing conditions that affect fluid homeostasis in the body.",
        "Sodium and Its Role in Fluid Balance": "sodium plays a vital role in regulating fluid balance total fluid volume and blood pressure in the human body it also facilitates muscle contraction and nerve impulse transmission making it critical for numerous physiologic functions electrolyte imbalances particularly involving sodium can lead to significant health issues hypertonic fluid deficit for instance occurs when there is a disproportionate loss of sodium relative to water loss leading to conditions such as hypernia which is characterized by a sodium level of 146 mil equivalents per liter or higher conversely hyponatremia occurs when the serum sodium level Falls to 134 mil equivalents per liter or lower several factors can cause hyper and hyponatremia excessive sweating either due to the Heat or strenuous exercise can lead to significant sodium loss GI losses such as those resulting from vomiting and diarrhea also contribute to these imbalances Additionally the inappropriate use of intravenous fluids or diuretics can disrupt sodium levels understanding these causes and the underlying mechanisms is important for effectively managing and treating electrolyte imbalances.",
        "Potassium Imbalances": "pottassium is vital for many cellular functions including maintaining cell membrane potential enabling muscle contraction and transmitting nerve impulses the normal serum potassium level ranges from 3.5 to 5 mil equivalents per liter deviations from this range can lead to significant health issues hypokalemia refers to a decreased serum potassium level causes include decreased dietary intake and absorption of potassium reduced shift of potassium into cells renal potassium loss and extr renal potassium loss which can occur through mechanisms such as gastrointestinal losses hyperemia on the other hand is characterized by an elevated serum potassium level it can result from decreased potassium excretion which might be due to renal insufficiency or the use of certain medications additionally shifts of potassium from within the cells to the extracellular space as well as excessive dietary potassium intake can contribute to hyperemia understanding the causes and effects of these imbalances is crucial for Effective diagnosis and management.",
        "Calcium Regulation and Imbalances": "calcium is a mineral with nearly 98% of it found in the bones and teeth where it lends strength and stability to the collagen and ground substance that form the Matrix of the skeletal system calcium enters the body through the GI tract and is maintained within a normal serum level range of 8.6 to 10.2 mg per deciliter hypocalcemia refers to a decreased serum calcium level the causes of hypocalcemia include decreased calcium intake or absorption increased calcium loss endocrine disorders such as hyperparathyroidism neoplasms especially those affecting the bones and various miscellaneous conditions that can affect calcium metabolism the regulation of blood calcium levels involves a series of processes to maintain homeostasis when blood calcium levels are low the parathyroid gland increases the secretion of parathyroid hormone or pth and the formation of calcitriol vitamin D3 in the kidney this leads to Greater absorption of dietary calcium in the intestines increased reabsorption of calcium in the kidneys to reduce excretion and the stimulation of the osteoclast activity to move calcium from the bone to the bloodstream conversely when blood calcium levels are high the thyroid gland secretes calcitonin which lowers blood calcium levels by inhibiting osteoclast activity and promoting calcium desposition into the bone additionally reduced pth and calcitrol formation decreases intestinal absorption of calcium and increases calcium excretion in the kidneys.",
        "Phosphate and Magnesium Imbalances": "phosphate is primarily an intracellular annion playing a role in many body functions hypo phosphatemia a condition characterized by decreased serum phosphate levels can result from several causes including decreased supply or absorption excessive loss associated with with the use of diuretics or impatients with Hyper parathyroidism hyperthyroidism or alcoholism other causes include the intracellular shift of phosphorus electrolyte abnormalities and abnormal loss of nutrients followed by inadequate replenishment on the other hand hyperphosphatemia is characterized by increased serum phosphate levels which can occur due to massive loading of phosphate into the extracellular fluid or decreased excretion in magnesium is an essential mineral with 50% stored in the bones 49% in other cells and 1% in the extracellular fluid the normal range of serum magnesium is 1.6 to 2.6 mil equivalents per liter hypom magnesia a condition marked by decreased serum magnesium levels can result from diminished magnesium absorption or intake increased renal loss of magnesium and various causes such as diabetes respiratory alkalosis and pregnancy conversely hyper magnesia characterized by an increased serum magnesium level almost always results from kidney insufficiency as the kidneys play a key role in magnesium excretion.",
        "Acid-Base Balance and Disorders": "acid base balance in the body is measured by pH which indicates the acidity or alkalinity of a solution a lower pH corresponds to higher acidity acidosis occurs when there's an increase in extracellular hydrogen ions leading to a decrease in PH conversely alkalosis happens when there is a decrease in extracellular hydrogen ions resulting in an increase in PH disturbances in acid base balance are often linked with disturbances in potassium balance as both ions are closely regulated within the body systems respiratory acidosis is a type of acidbase imbalance that is always related to hypoventilation leading to an increased concentration of carbon dioxide in the blood causes of respiratory acidosis include Airway obstruction Cardiac Arrest overdose of a CNS depressant drug such as heroin submersion respiratory arrest pulmonary edema closed head injury and chest trauma the signs and symptoms of respiratory acidosis can include systemic and or cerebral vasod dilation headache light headedness warm and flush skin CNS depression slow respiratory rate and nausea vomiting recognizing and addressing the underlying causes are important for managing respiratory acidosis effectively respiratory alkalosis is associated with conditions that lead to hyperventilation which reduces the level of circulating carbonic acid in the body the classic sign of respiratory alkalosis is hyperventilation accompanied by carpopedal spasm the primary causes of this condition include drug overdose fever and overzealous bag mask ventilation during medical interventions the signs and symptoms of respiratory alkalosis include a diminished level of Consciousness Li headedness carpopedal spasm paresthesia of the lips and face chest tightness confusion vertigo blurred vision nausea and vomiting metabolic acidosis on the other hand refers to any acidosis unrelated to the respiratory system the causes of metabolic acidosis include lactic acidosis keto acidosis aspirin overdose excessive alcohol ingestion leading to alcoholic keto acidosis GI losses and carbon monoxide poisoning signs and symptoms include vasodilation CNS depression headaches warm and flush skin to kitney nausea vomiting and cardiac drimia metabolic alkalosis occurs due to an excessive loss of acid and is rarely an acute condition but is common among chronically ill patients the causes of metabolic alkalosis include excessive vomiting excessive water intake nasogastric suctioning and excessive intake of alkaline substances the signs and symptoms of metabolic alkalosis include confusion muscle Tremors and cramps bradia and hypotension understanding these conditions and their manifestations is essential for accurate diagnosis and effective treatment.",
        "Cellular Injury and Repair": "various processes can lead to Cellular injury each disrupting normal cell function and viability ility in different ways hypoxia or lack of oxygen deprives cells from the oxygen needed for aerobic respiration and energy production es schia or a lack of blood supply also reduces oxygen delivery and limits the removal of metabolic wastes chemical injury can result from exposure to toxic substances that disrupt cellular structures or metabolic pathways infectious injury is caused by pathogens such as bacteria viruses or fungi that invade and damage cells immunologic injury including hyper sensitivity reactions occurs when the immune system mistakenly attacks the body's own cells physical damage or mechanical injury results from trauma that physically disrupts cell membrane and structures lastly inflammatory injury involves the damaging effects of chronic inflammation where prolonged immune responses can harm tissues understanding these processes is critical for diagnosing and treating conditions resulting from cellular injury manifestations of cellular injury occur at both microscopic and functional levels common microscopic abnormalities include cell swelling rupture of cell membranes or nuclear membranes and breakdown of nuclear material such as chromosomes these structural changes can significantly impact cellular integrity and function functional disturbances resulting from cellular injury may include inefficient oxygen utilization leading to energy deficits within the cell intracellular acidosis can occur as a result of anerobic metabolism causing a decrease in PH and affecting cellular processes toxic waste accumulation can disrupt cellular homeostasis and metabolic functions Additionally the derangement of nutrient metabolization can impair the cell's ability to synthesize essential molecules and generate energy dysfunction in one system inevitably affects the function of other systems due to the interconnected nature of cellular and organ functions however cellular injury can be repaired to a certain extent with proper treatment allowing for the restoration of normal function and prevention of further damage.",
        "Hypoxic and Chemical Injury": "hypoxic injury is a common and often fatal cause of cellular injury resulting from inadequate oxygen supply to tissues several factors can lead to hypoxia including decreased oxygen levels in the air loss of hemoglobin function a decreased number of red blood cells and diseases affecting the respiratory or cardiovascular systems Additionally the loss of cytochromes which are essential for cellular respiration can also cause hypoxic injury when cells experience hypoxia for more than a few seconds they begin to produce mediators that can cause further damage among these mediators free radicals are the earliest and most harmful free radicals are highly reactive molecules that can damage cellular components such as lipids proteins and DNA leading to further cell injury and death chemical injury involves damage to cells caused by a variety of harmful chemicals which can ultimately lead to cell destruction common poisons that cause chemical injury include cide and pesticides cyanide induces cell hypoxia by inhibiting cellular respiration thus preventing cells from utilizing oxygen effectively pesticides on the other hand block the enzyme acetool estras which is essential for the proper transmission of nerve impulses leading to nervous system dysfunction long-term ingestion of lead can result in brain injury and neurological dysfunction due to its toxic effects on the nervous system carbon monoxide a colorless and odorless gas binds to hemoglobin more effectively than oxygen thus preventing adequate oxygenation of tissues and leading to hypoxic injury higher doses of ethanol can cause severe central nervous system depression and hypoventilation which can further exacerbate hypoxia and cellular damage.",
        "Infectious and Immunologic Injury": "infectous injury occurs as a result of the invasion of bacteria fungi or viruses the virulence of a microorganism measures its disease causing availability when the immune system is depressed it becomes less capable of fighting off these microorganisms upon cellular injury circulating white blood cells are attracted to the site of injury and release endogenous pyogens which cause fever septicemia or sepsis is a systemic disease caused by the proliferate eration of microorganisms or their related toxins in the blood viruses in particular take over the metabolic processes of the host cell and use the cell to replicate a virus consists of a nucleic acid core which can be either RNA or DNA viral infection of a host cell leads to decreased synthesis of macro molecules vital to The Host cell thereby disrupting its normal function and contributing to Cellular injury many bacteria possess a capsule that protects them from ingestion and destruction by fyes the immune cells that are responsible for engulfing and digesting foreign particles and pathogens this capsule is an important virulence Factor allowing bacteria to evade the host immune defenses when bacteria manag to enter the bloodstream this condition is referred to as bacteremia bacteremia can lead to Serious systemic infections and requires prompt medical intervention to prevent complications such as sepsis immunologic and inflammatory injuries involve the body's protective response to Cellular injury inflammation is is a defense mechanism that occurs in response to physical chemical or microbiological agents causing cellular damage the classic signs of inflammation include heat redness tenderness swelling and pain these symptoms result from increased blood flow and the accumulation of immune cells at the sight of injury to facilitate healing and prevent infection when the inflammatory response is severe systemic effects may become evident a person experiencing severe inflammation might feel generally ill and their body temperature May Elevate as part of the fever response Additionally the bone marrow accelerates its production of lucaites leading to lucco cytosis which helps in fighting off infections more effectively the outcome of immunologic and inflammatory injuries depends largely on the extent of tissue damage mild inflammation typically resolves with minimal tissue damage while severe or chronic inflammation can lead to significant tissue injury and potential complications.",
        "Wound Healing and Inflammation": "injury resolution and repair follow four essential steps repair of damaged tissue removal of inflammatory debris restoration of tissues at to a normal State and regeneration of cells wound healing can occur by primary or secondary intention primary intention is observed to clean wounds with the Pressed margins while secondary intention occurs in large gaping or infected wounds characterized by a more pronounced and prolonged inflammatory phase dysfunctional wound healing can be influenced by local factors such as infection inadequate blood supply and fign bodies or systemic factors like inadequate nutritional intake leading to insufficient collagen levels interference with epithelialization or wound contraction hematologic abnormalities diabetes AIDS and the use of corticosteroids chronic inflammatory responses typically result from an unsuccessful acute inflammatory response these responses are associated with an infiltrate containing monocytes and lymphocytes and they often involve tissue destruction and repair which may lead to scar formation when tissue injury occurs it triggers the release of various chemicals such as histamine complement prostaglandins and others these chemicals play crucial roles in the inflammatory response firstly they attract white blood cells including nutrifil macrofagos and monoy to the injured area this migration is essential for the subsequent steps of inflammation and healing the chemicals also increase capillary permeability allowing white blood cells to stick to and pass through the capillary walls this process facilitates the movement of these cells to the site of injury where they can fze bacteria and dead tissue cells leading to the formation of pus in some cases debris is eventually removed by the white blood cells aiding in the cleaning of the injured site additionally these chemicals cause dilation of blood vessels which releases blood flow to the injured area this increased blood flow results in redness and heat common signs of inflammation dilation also allows clotting factors to enter the injured area leading to the formation of a blood clot that walls off the area and prevents further loss of blood increased blood flow and capillary permeability also lead to an increase in oxygen and nutrient supply to the injured area which is vital for healing however plasma leaking into tissues causes swelling in pain swelling can temporarily restrict movement while the increased temperature associated with inflamation raises the metabolic rate of cells promoting the healing process.",
        "Hypersensitivity and Immune Responses": "hypers sensitivity refers to any exaggerated or inappropriate response of the immune system to a foreign substance to which a patient has increased sensitivity there are sever several types of hypers sensitivity reactions each with distinct mechanisms and effects on the body allergy is a common form of hypers sensitivity reaction to an external agent autoimmunity involves the production of antibodies or te- cells that attack the body's own tissues ISO immunity occurs when te- cells or antibodies are formed against antigens on another person's cell cells there are four types of hyper sensitivity reactions type one immediate hypers sensitivity reactions occur in response to a stimulus and can vary in severity from mild to life-threatening type two cytotoxic hypers sensitivity reactions occur when cells are destroyed by complement fixation or other antibodies type three immune complex mediated tissue uies can be systemic such as serum sickness resulting from a large single exposure to an antigen or localized like an arthus reaction lastly we have type four delayed cell mediated hypers sensitivity which includes two subtypes delayed hypers sensitivity and cell mediated cyto toxicity this image illustrates the process of a type one hypers sensitivity reaction which involves two main stages the sensitivity stage and secondary response during the sensitivity stage an antigen or allergen enters the body leading to the synthesis and release of IG antibodies by plasma cells these antibodies bind a mass cells located in various body tissues arming them with histamine containing granules upon subsequent exposure to the same allergen the allergen binds to the IG antibodies on the mass cells triggering the release of histamine and other chemicals histamine stimulates the dilation of blood vessels causing fluid leakage stimulates mucus production and causes the contraction of smooth muscles in the bronchials this leads to symptoms such as fluid leakage from the capillaries copious mucus release and constriction of the small respiratory passages the immune system targets different molecules depending on the type of hyper sensitivity reaction in allergic reactions the target is an antigen or allergen in autoimmune reactions the immune system targets a person's own tissues which can lead to diseases such as Graves disease type 1 diabetes metis rheumatoid arthritis mythia gravis and systemic lupus immune deficiencies can be congenital or acquired immuno deficiency is characterized by an inadequate immune system leading to decreased resistance to infectious diseases congenital immuno deficiencies involve inherited defects in lymphoid stem cells acquired imuno deficiencies can result from nutritional deficiencies trauma or treatment induced causes such as medications there is replacement therapy available in order to treat these imuno deficiencies.",
        "Disease Risk Factors": "factors that cause disease can be broadly categorized into genetic environmental age related and sex Associated factors genetic factors include inherited conditions and mutations that predispose individuals to certain diseases environmental factors Encompass external influences such as pollution lifestyle choices and exposure to harmful substances age related factors reflect the increased susceptibility to diseases that come with aging due to the Natural decline in bodily functions sex Associated factors involve the differences in disease prevalence and susceptibility between males and females which can be attributed to hormonal differences genetic variations and social behaviors risk factors for diseases can be classified into controllable and uncontrollable categories uncontrollable factors include genetics and race which inherently influence the likelihood of developing certain diseases on the other hand many risk factors such as smoking alcohol consumption poor nutrition lack of physical activity and stress are controllable through lifestyle changes the risk of developing particular diseases also varies with age reflecting age related changes in the body additionally sex can be related to the risk of certain diseases due to hormonal and physiological differences between males and females analysis of disease risk involves evaluating disease rates and identifying risk factors causal factors are those that directly cause a disease to develop while non-causal factors are associated with the disease but do not directly cause it effective disease studies should consider incidents or new cases prevalence total cases and morality furthermore the interaction between risk factors age and sex differences is crucial for understanding and analyzing disease risk comprehensively common familial diseases and Associated risk factors include genetic risks that are passed through generations by inheritance of a gene some diseases exhibit a familial tendency clustering in family groups despite a lack of evidence for heritable Gene Associated abnormalities additionally immunologic diseases are often caused by either hypera activity or hypoactivity of the immune system this illustration shows the pathogenesis of allergy first exposure to an allergen induces the formation of specific immunoglobin antibodies in susceptible patients which then bind to mass cells and basophils subsequent exposure to the same allergen leads to antigen antibody interaction through through activation of memory cells liberating histamine and other mediators from mass cells and basophils these mediators induce allergic manifestations.",
        "Cancer and Endocrine Disorders": "cancer describes the pathology associated with malignant growths or neoplasms in various anatomic areas the prognosis often depends on the extent of its spread or metastasis and the effectiveness of treatment a major risk factor associated with lung cancer is cigarette smoking breast cancer is the most common type of cancer among women while color rectal cancer is the third most common type of cancer in women and men diabetes metis is one of the most significant endocrine diseases associated with either partial insulin secretion or a total lack of insulin secretion by the pancreas it can be characterized as keto acidosis prone type one or insulin dependent diabetes and non-keto acidosis prone type 2 or non-insulin dependent diabetes.",
        "Hematologic and Cardiovascular Disorders": "hematologic disorders Encompass conditions such as hemolytic anemia hemophilia and hemat chromatosis H humic anemia is characterized by The increased destruction of red blood cells and can result from various causes including Rh factor blood transfusion reactions immune system disorders and exposure to bacterial toxins or chemicals like Benzene hemophilia is an inherited disorder marked by excessive bleeding due to the absence or AB normally low levels of one of the blood clotting proteins that's necessary for normal blood coagulation hematosis is an inherited disease where the body absorbs more iron than it needs leading to iron overload cardiovascular disorders include conditions such as cardiomyopathy mitrov valve prolapse coronary artery disease hypertension and stroke cardiomyopathy refers to diseases of The myocardium which is the heart muscle mitro valve prolapse is a condition where the valve between the heart's left atrium and left ventricle doesn't close properly coronary heart disease involves the narrowing or blockage of coronary arteries hypertension is high blood pressure which can lead to many severe Health complications and lastly a stroke occurs when the blood supply to part of the brain is interrupted or reduced preventing blood tissue from getting oxygen and nutrients this illustration demonstrates a comparison between normal cardiac function and the malfunction characteristic of hypertropic cardiomyopathy in A Normal Heart the image shows the unobstructed flow of blood from the left ventricle into the aorta during ventricular syy this ensures efficient circulation however in figure B we see hypertrophic cardiomyopathy here the illustration highlights an obstruction to the outflow of blood from the left ventricle that's caused by a hypertrophied septum this thickened septum impinges on the interior leaf split of the mitro valve which can disrupt normal blood flow and potentially lead to complications such as heart failure or arrhythmias.",
        "Renal and Gastrointestinal Disorders": "looking at renal disorders we'll first talk about gout gout is a type of arthritis that occurs when there is an excess of uric acid in the blood leading to the formation of urate crystals in the joints these crystals can cause sudden s severe episodes of pain tenderness redness warmth and swelling wow gal primarily affects the joints it can also lead to kidney stones and other renal complications due to the desposition of uric acid crystals in the kidneys speaking of the kidneys kidney stones are hard deposits made of minerals and salts that form inside the kidneys they can be caused by various factors especially diet and excess body weight but also due to certain medical conditions as well as certain supplements and medications kidney stones can affect any part of the urinary tract from the kidneys to the bladder passing kidney stones are ex usually very painful however the stones typically cause no permanent damage if they're recognized in a Time fashion malabsorption disorders occur when the intestines cannot absorb nutrients from food effectively this can lead to deficiencies in vitamins minerals proteins and other essential nutrients causing a variety of symptoms such as weight loss diarrhea and anemia common causes include celiac disease Chron chronic pancreatitis in certain surgical procedures lactose intolerance is the inability to digest lactose the sugar found in milk and dairy products this occurs due to a deficiency of lactase the enzyme that's responsible for breaking down lactose in the digestive system patients will typically complain of bloating diarrhea and abdominal cramps immediately after consuming dairy product prodcts alterative colitis is a chronic inflammatory condition of the colon and rectum it causes inflammation in ulcers in the lining of the colon leaning to symptoms such as abdominal pain diara rectal bleeding and an urgent need to defecate is part of a group of conditions known as inflammatory bowel disease or IBD speaking of IBD Crohn's disease is a type of inflammatory bowel disease that can affect any part of the GI tract from the mouth to the anus it causes inflammation which can lead to abdominal pain severe diarrhea fatigue weight loss and malnutrition the inflammation often spreads deep into the layers or affected bowel tissue peptic Ultra disease involves the formation of sores or ulcers in the lining of the stomach lower esophagus or small intestine these ulcers are typically caused by hpylori infection or the long-term use of non-steroidal anti-inflammatory drugs or incets patients typically complain of a burning stomach pain bloating and heartburn gallstones are solid particles that form from bio cholesterol and B Rubin in the gallbladder they can block the flow of bile in the gallbladder causing intense pain in the upper right abdomen jaundice and sometimes infection definitive treatment often involves surgical removal of the gallbladder obesity is defined as having a BMI greater than 30 it is a significant health issue associated with an increased risk of various diseases including type 2 diabetes cardiovascular disease certain types of cancer and GI disorders obesity results from a combination of genetic environmental and lifestyle factors.",
        "Neuromuscular and Psychiatric Disorders": "neuromuscular disorders Encompass a range of conditions that affect the muscles and their direct nervous system control Huntington disease is a genetic disorder characterized by the progressive breakdown of nerve cells in the brain leading to motor dysfunction cognitive decline and psychiatric symptoms muscular distrophy refers to a group of genetic diseases that cause Progressive weakness and loss of muscle mass due to abnormalities in the muscle proteins multiple sclerosis is is an immune disease in which the immune system attacks the protective covering of nerves resulting in communication problems between the brain and the rest of the body Alzheimer's disease is a progressive neurodegenerative disorder that leads to memory loss cognitive decline and ultimately the inability to carry out simple tasks psychiatric disorders often have a complex interplay of genetic and environmental factors some common psychiatric disorders are believed to have a familial or genetic component suggesting a hereditary predisposition to these conditions schizophrenia is a severe mental disorder that is characterized by distorted thinking perceptions emotions language sense of self and behavior bipolar disorder is marked by extreme mood swings that include emotional highs and lows this can severely impact daily functioning and quality of life.",
        "Stress and Its Physiological Impact": "stress encompasses a wide range of intense external stimuli both physiological and psychological with the psychological stress causing a physiological response as well this physiological stress necessitates cellular adaptation within the body concepts related to this type of stress include the nature of the stresser an impact on the body and the body's response to the stress the General Adaptation Syndrome describes a three-stage reaction to stressors both physical and emotional the alarm stage or first stage involves the initial reaction to stress where the body releases catacol amines this is followed by the resistance or adaptation stage where the body adjusts to the stressors by stimulating the adrenal gland to secrete glucocorticoids and mineral corticoids the anterior pituitary gland releases adrenocorticotropic hormone or act as well as endorphins this final stage exhaustion occurs when the adrenal glands become depleted leading to decreased blood glucose levels this stage is characterized by decreased stress tolerance Progressive mental and physical exhaustion illness and potentially collapse the image illustrates the physiological mechanisms involved in the body's response dist stress particularly highlighting the roles of the hypothalamus pituitary gland and adrenal glands when the body encounters a stressor the hypothalamus activates the pituitary gland which releases adrenocorticotropic hormone act then stimulates the adrenal cortex to secrete gluto corticoids while the Adrenal medulla releases adrenaline or epinephrine the secretion of glucocorticoids increases access to energy storage and accelerates body metabolism concurrently adrenaline boosts heart rate breathing rate and blood glucose levels preparing the body for the fight or flight response this complex interaction between the pituitary adrenal axis and the sympathoadrenal pathway way ensures that the body can quickly and efficiently respond to stress enhancing both physical and metabolic Readiness the image illustrates the body's hormonal response to stress focusing on the hypothalmic pituitary adrenal axis when the body experiences stress the hypothalamus secretes acrh or adrenocorticotropic hormone releasing hormone this signals the anterior pituitary gland to release act in the bloodstream which then stimulates the adrenal cortex to produce and release cortisol a glucocorticoid hormone cortisol plays a crucial role in the body stress response by mobilizing energy reserves and modulating various metabolic processes it increases blood glucose levels through glucogenesis and inhibits glucose uptake by tissues ensuring an adequate energy supply for vital organs and muscles additionally cortisol elevates blood concentrations of amino acids by promoting protein degradation and increases the levels of fatty acids by stimulating lipolysis these metabolic changes provide the necessary Fuel and building blocks to help the body cope with and adapt to stress the dial Rhythm also influences cortisol secretion highlighting the interplay between stress and the body's internal clock chronic stress exerts its effects primarily through the hypothalamic pituitary adrenal axis which governs the body's reactions to stress prolonged exposure to stress can disrupt the normal regulatory functions of the HPA axis this disruption results in the continuous production of cortisol by the adrenal glands which overtaxes the body's Stress Management System persistently High cortisol levels can lead to fatigue and depression as well as interfere with the activity of Serotonin a neurotransmitter associated with mood regulation additionally elevated cortisol levels ere extended periods of time suppress the immune system making the body more susceptible to infections and diseases the effectiveness of an individual's coping mechanisms significantly influences their physiological response to stress effective coping strategy IES can help mitigate the adverse effects of chronic stress by enhancing the immune system's function and maintaining overall health therefore fostering robust coping mechanisms is vital for managing chronic stress and preventing its detrimental Health impacts.",
        "Importance of Pathophysiology for AEMTs": "for an advanced emergency medical technician a fundamental understanding of pathophys iology is vital as it underpins their ability to assess and manage complex medical conditions effectively pathophysiology provides providers with insights into how various medical conditions and injuries impact the body this knowledge enables them to interpret symptoms accurately prioritize treatments and make informed decisions during emergencies by understanding the underlying mechanisms of diseases aemts can better anticipate complications and respond with the appropriate interventions moreover a solid grasp of pathophysiology enhances a provider's capability to communicate effectively with other Health Care Professionals this understanding allows them to articulate the patient's condition and the rationale behind their treatment decisions facilitating more coordinated and efficient care in critical situations where time is of the essence this depth of knowledge ensures that interventions are targeted and evidence-based ultimately improving patient outcomes and the overall efficacy of Emergency Medical Services"
    },
    {
        "Key Terms": "Anatomy: The study of structures, including gross anatomy (structures that can be seen with the naked eye) and microscopic anatomy (structures seen under the microscope)., Body system: A group of organs and other structures that works together to carry out specific functions., Cells: The basic units that combine to form all living tissue., Circulatory system: A group of organs and other structures that carries oxygen-rich blood and other nutrients throughout the body and removes waste., Digestive system: A group of organs and other structures that digests food and eliminates wastes., Endocrine system: A group of organs and other structures that regulates and coordinates the activities of other systems by producing chemicals (hormones) that influence tissue activity., Genitourinary system: A group of organs and other structures that eliminates waste and enables reproduction., Integumentary system: A group of organs and other structures that protects the body, retains fluids and helps to prevent infection., Musculoskeletal system: A group of tissues and other structures that supports the body, protects internal organs, allows movement, stores minerals, manufactures blood cells and creates heat., Nervous system: A group of organs and other structures that regulates all body functions., Organ: A structure of similar tissues acting together to perform specific body functions., Physiology: How living organisms function (e.g., movement and reproduction)., Respiratory system: A group of organs and other structures that brings air into the body and removes wastes through a process called breathing, or respiration., Tissue: A collection of similar cells acting together to perform specific body functions., Vital organs: Those organs whose functions are essential to life, including the brain, heart and lungs.",
        "INTRODUCTION": "As an emergency medical responder (EMR), you require a basic understanding of normal human structure and function. Knowing what the body\u2019s structures are and how they work will help you more easily recognize and understand injuries and illnesses. Body systems do not function independently. Each system depends on other systems to function properly. When your body is healthy, your body systems work well together. But an injury or illness in one body part or system will often cause problems in others. Knowing the location and function of the major organs and structures within each body system will help you to more accurately assess a patient\u2019s condition and provide the best care. To remember the location of body structures, it is important to visualize the structures that lie beneath the skin. The structures you can see or feel are reference points for locating the internal structures you cannot see or feel. For example, to locate the pulse on either side of the neck, you can use the middle of the throat as a reference point. Using reference points will help you describe the location of injuries and other conditions you may find. This chapter provides you with an overview of important reference points, terminology and the functions of eight of the body systems. It also focuses on body structure (anatomy) and body function (physiology).",
        "MEDICAL TERMINOLOGY": "In order to have a common language with which healthcare providers can accurately communicate about patients, it is important to have a basic understanding of medical terminology. One of the key elements to understanding medical terminology is to break down the terms into their parts. Medical terms often are constructed using a combining form (root word plus a combining vowel) that contains the meaning, plus a suffix (word ending) that has its own meaning and/or a prefix (word beginning). For example, the medical term \u201cendotracheal\u201d is made up of the combining form \u201ctrache,\u201d which means trachea; the prefix \u201cendo,\u201d which means within; and the suffix \u201cal,\u201d which means pertaining to. By understanding the parts of the word, we understand the term endotracheal to mean \u201cpertaining to something within the trachea.\u201d This term might be used with the word \u201ctube,\u201d to describe a type of tube used within the trachea. The easiest way to learn medical combining forms (Table 4-1), their prefixes and their suffixes is to memorize them. A few of the more common prefixes are: hypo- (below normal), hyper- (above normal), a- (without, no), tachy- (fast) and brady- (slow) (Table 4-2). A few of the more common suffixes are: -emic (pertaining to the blood), -emia (condition of the blood) and -a or -ia (condition).",
        "Directions and Locations": "By knowing a few key locations of structures and how to describe them, you can more accurately recognize a serious injury or illness and communicate with other emergency medical services (EMS) personnel about a patient\u2019s condition.",
        "Anterior/posterior": "Any part toward the front of the body is anterior; any part toward the back is posterior.",
        "Superior/inferior": "Superior describes any part toward the patient\u2019s head; inferior describes any part toward the patient\u2019s feet.",
        "Frontal or coronal plane": "That which divides the body vertically into two planes, anterior (the patient\u2019s front) and posterior (the patient\u2019s back).",
        "Sagittal or lateral plane": "That which divides the body vertically into right and left planes.",
        "Transverse or axial plane": "That which divides the body horizontally, into the superior (above the waist) and inferior (below the waist) planes.",
        "Medial/lateral": "The terms medial and lateral refer to the midline, an imaginary line running down the middle of the body from the head to the ground and creating right and left halves. Any part toward the midline is medial; any part away from the midline is lateral.",
        "CRITICAL FACTS": "Knowing locations of anatomical structures and how to describe them will help you recognize a serious injury or illness and help you better communicate with other EMS personnel.",
        "Proximal/distal": "Proximal refers to any part close to the trunk (chest, abdomen and pelvis); distal refers to any part away from the trunk and nearer to the extremities (arms and legs).",
        "Superficial/deep": "Superficial refers to any part near the surface of the body; deep refers to any part far from the surface.",
        "Internal/external": "Internal refers to the inside and external to the outside of the body.",
        "Right/left": "Right and left always refer to the patient\u2019s right and left, not yours.",
        "Movements": "Flexion is the term used to describe flexing or a bending movement, such as bending at the knee or making a fist. Extension is the opposite of flexion\u2014that is, a straightening movement. The prefix \u201chyper\u201d used with either term describes movement beyond the normal position.",
        "Positions": "As a responder, you will often have to describe a patient\u2019s position to other EMS personnel and healthcare providers. Using correct terms will help you communicate the extent of a patient\u2019s injury quickly and accurately. Terms used to describe body positions include: \uf0a7 Anatomical position. This position, where the patient stands with body erect and arms down at the sides, palms facing forward, is the basis for all medical terms that refer to the body. \uf0a7 Supine position. The patient is lying face-up on their back. \uf0a7 Prone position. The patient is lying face-down on their stomach. \uf0a7 Right and left lateral recumbent position. The patient is lying on their left or right side. \uf0a7 Fowler\u2019s position. The patient is lying on their back, with the upper body elevated at a 45\u00b0 to 60\u00b0 angle.",
        "Body Cavities": "The organs of the body are located within hollow spaces in the body referred to as body cavities. The five major cavities include the: \uf0a7 Cranial cavity. Located in the head and is protected by the skull. It contains the brain. \uf0a7 Spinal cavity. Extends from the bottom of the skull to the lower back, is protected by the vertebral (spinal) column and contains the spinal cord. \uf0a7 Thoracic cavity (chest cavity). Located in the trunk between the diaphragm and the neck, and contains the lungs and heart. The rib cage, sternum and the upper portion of the spine protect it. The diaphragm separates this cavity from the abdominal cavity.",
        "Abdominal cavity": "Located in the trunk below the ribs, between the diaphragm and the pelvis. It is described using four quadrants created by imagining a line from the breastbone down to the lowest point in the pelvis and another one horizontally through the navel. This creates the right and left, upper and lower quadrants. The abdominal cavity contains the organs of digestion and excretion, including the liver, gallbladder, spleen, pancreas, kidneys, stomach and intestines.",
        "Pelvic cavity": "Located in the pelvis, and is the lowest part of the trunk. Contains the bladder, rectum and internal female reproductive organs. The pelvic bones and the lower portion of the spine protect it. Further description of the major organs and their functions are in the next section of this chapter and in later chapters.",
        "Musculoskeletal system": "Major Structures: Bones, ligaments, muscles and tendons. Primary Functions: Provides the body\u2019s framework; protects internal organs and other underlying structures; allows movement; produces heat; manufactures blood components. System Interactions: Provides protection to organs and structures of other body systems; muscle action is controlled by the nervous system.",
        "Respiratory system": "Major Structures: Airway and lungs. Primary Functions: Supplies the body with oxygen and removes carbon dioxide and other impurities through the breathing process. System Interactions: Works with the circulatory system to provide oxygen to cells; is under the control of the nervous system.",
        "Circulatory system": "Major Structures: Heart, blood and blood vessels. Primary Functions: Transports nutrients and oxygen to body cells and removes waste products. System Interactions: Works with the respiratory system to provide oxygen to cells; works with the urinary and digestive systems to remove waste products; helps give skin color; is under the control of the nervous system.",
        "Nervous system": "Major Structures: Brain, spinal cord and nerves. Primary Functions: One of two primary regulatory systems in the body; transmits messages to and from the brain. System Interactions: Regulates all body systems through a network of nerve cells and nerves.",
        "Integumentary system": "Major Structures: Skin, hair and nails. Primary Functions: An important part of the body\u2019s communication network; helps prevent infection and dehydration; assists with temperature regulation; aids in production of certain vitamins. System Interactions: Helps protect the body from disease-producing organisms; helps regulate body temperature with the circulatory system; communicates sensation to the brain by way of the nerves.",
        "Endocrine system": "Major Structures: Glands. Primary Functions: Secretes hormones and other substances into the blood and onto the skin. System Interactions: Together with the nervous system, coordinates the activities of other systems.",
        "Digestive system": "Major Structures: Mouth, esophagus, stomach and intestines. Primary Functions: Breaks down food into a usable form to supply the rest of the body with energy. System Interactions: Works with the circulatory system to transport nutrients to the body and remove waste products.",
        "Genitourinary system": "Major Structures: Uterus, genitalia, kidneys and bladder. Primary Functions: Performs the processes of reproduction; removes wastes from the circulatory system and regulates water balance. System Interactions: Assists in regulating blood pressure and fluid balance.",
        "CIRTICAL FACTS": "The organs of the body are located within hollow spaces in the body referred to as body cavities. The five major cavities include the cranial, spinal, thoracic (chest), abdominal and pelvic cavity.",
        "BODY SYSTEMS": "The human body is a miraculous machine. It performs many complex functions, each of which helps us live. The human body is made up of billions of different types of cells that contribute in special ways to keep the body functioning normally. Similar cells form together into tissues, and these in turn form together into organs. Vital organs such as the brain, heart and lungs are organs whose functions are essential for life. Each body system contains a group of organs and other structures that are especially adapted to perform specific body functions needed for life. For example, the circulatory system consists of the heart, blood and blood vessels. This system keeps all parts of the body supplied with oxygen-rich blood. For the body to work properly, all of the following systems must work well together:\n\uf0a7 Musculoskeletal\n\uf0a7 Respiratory\n\uf0a7 Circulatory\n\uf0a7 Nervous\n\uf0a7 Integumentary\n\uf0a7 Endocrine\n\uf0a7 Digestive\n\uf0a7 Genitourinary",
        "The Musculoskeletal System": "The musculoskeletal system is a combination of two body systems, the muscular and skeletal systems, and consists of the bones, muscles, ligaments and tendons. This system performs the following functions:\n\uf0a7 Supports the body\n\uf0a7 Protects internal organs\n\uf0a7 Allows movement\n\uf0a7 Stores minerals\n\uf0a7 Produces blood cells\n\uf0a7 Produces heat\nThe adult body has 206 bones. Bone is hard, dense tissue that forms the skeleton. The skeleton forms the framework that supports the body. Where two or more bones join, they form a joint. Fibrous bands called ligaments usually hold bones together at joints. Bones vary in size and shape, allowing them to perform specific functions. Tendons connect muscles to bone.",
        "The Muscular System": "The muscular system allows the body to move. Muscles are soft tissues. The body has more than 600 muscles, most of which are attached to bones by strong tissues called tendons. Muscle tissue has the ability to contract (become shorter and thicker) when stimulated by a tiny jolt of an electrical or nerve impulse. Muscle cells, called fibers, are usually long and threadlike and are packed closely together in bundles, which are bound together by connective tissue.\nThe three types of muscles are skeletal (voluntary), smooth (involuntary) and cardiac.",
        "Skeletal": "Skeletal, or voluntary, muscles are under the control of the brain and nervous system. These muscles help give the body its shape and make it possible to move when we walk, smile, talk or move our eyes.",
        "Smooth": "Smooth muscles, also called involuntary muscles, are made of longer fibers and are found in the walls of tube-like organs, ducts and blood vessels. They also form much of the intestinal wall.",
        "Cardiac": "Cardiac muscles are only found in the walls of the heart and share some of the properties of the other two muscle types: they are smooth (like the involuntary muscles) and striated (string-like, like the voluntary muscles). They are a special type of involuntary muscle that controls the heart. Cardiac muscles have the unique property of being able to generate their own impulse independent of the nervous system.",
        "The Skeletal System": "The skeleton is made up of six sections: the skull, spinal column, thorax, pelvis, and upper and lower extremities.",
        "The skull": "The skull is made up of two main parts: the cranium and the face. The cranium is made up of broad, flat bones that form the top, back and sides, as well as the front, which house the brain. Thirteen smaller bones make up the face, as well as the hinged lower jaw, or mandible, which moves freely.",
        "The spinal column": "The spinal column, or spine, houses and protects the spinal cord. It is the principal support system of the body. The spinal column is made up of 33 small bones called vertebrae, 24 of which are movable. They are divided into five sections of the spine: 7 cervical (neck), 12 thoracic (upper back), 5 lumbar (lower back), and 9 sacral (lower spine with fused vertebrae) and coccyx (tailbone).",
        "The thorax": "The thorax, also known as the chest, is made up of 12 pairs of ribs, the sternum (breastbone) and the thoracic spine. Ten pairs of ribs are attached to the thoracic vertebrae and sternum with cartilage, while the bottom two pairs of ribs, known as the floating ribs, are attached only to the thoracic vertebrae. Together, these structures protect the heart and lungs.",
        "The pelvis": "The pelvis, also known as the hip bones, is made up of several bones, including the ilium, pubis and ischium. The pelvis supports the intestines and contains the bladder and internal reproductive organs.",
        "Upper extremities": "The upper extremities, or upper limbs, include the shoulders, upper arms, forearms, wrists and hands. The upper arm bone is the humerus, and the two bones in the forearm are the radius and the ulna. The upper extremities are attached to the trunk at the shoulder girdle, made up of the clavicle (collarbone) and scapula (shoulder blade).",
        "Lower extremities": "The lower extremities, or lower limbs, consist of the hips, upper and lower legs, ankles and feet. They are attached to the trunk at the hip joints. The upper bone is the femur or thigh bone, and the bones in the lower leg are the tibia and fibula. The kneecap is a small triangular-shaped bone, also called the patella.",
        "Joints": "Joints are the places where bones connect to each other. Strong, tough bands called ligaments hold the bones at a joint together. Most joints allow movement but some are immovable, as in the skull, and others allow only slight movement, as in the spine. All joints have a normal range of motion\u2014an area in which they can move freely without too much stress or strain. The most common types of moveable joints are the ball-and-socket joint, such as the hip and shoulder, and the hinged joint, such as the elbow, knee and finger joints. Different types of joints allow different degrees of flexibility and movement. Some other joint types include pivot joints (some vertebrae), gliding joints (some bones in the feet and hands), saddle joints (ankle) and condyloid joints (wrist).",
        "The Respiratory System": "The body can only store enough oxygen to last for a few minutes. The simple acts of inhalation and exhalation in a healthy person are sufficient to supply normal oxygen needs. If for some reason the oxygen supply is cut off, brain cells will begin to die in about 4 to 6 minutes, with certain permanent brain damage occurring after 10 minutes. The respiratory system delivers oxygen to the body, and removes carbon dioxide from it, in a process called respiration.",
        "Upper Airway": "The upper airway includes the nose, mouth and teeth, tongue and jaw, pharynx (throat), larynx (voicebox) and epiglottis. During inspiration (breathing in), air enters the body through the nose and mouth, where it is warmed and moistened. Air entering through the nose passes through the nasopharynx (part of the throat posterior to the nose), and air entering by the mouth travels through the oropharynx. The air then continues.",
        "Lower Airway": "The lower airway consists of the trachea (windpipe), bronchi, lungs, bronchioles and alveoli. Once the air passes through the larynx, it travels down the trachea, the passageway to the lungs. The trachea is made up of rings of cartilage and is the part that can be felt at the front of the neck. Once air travels down the trachea, it reaches the two bronchi, which branch off, one to each lung. These two bronchi continue to branch off into smaller and smaller passages called bronchioles, like the branches of a tree. At the ends of each bronchiole are tiny air sacs called alveoli, each surrounded by capillaries (tiny blood vessels). These are the site of carbon dioxide and oxygen exchange in the blood. The lungs are the principal organs of respiration and house millions of tiny alveolar sacs.",
        "Lower Airway - Pediatric Considerations": "The structures involved in respiration in children and infants differ from those of adults. They are usually smaller or less developed in children and infants. Some of these differences are important when providing care. Because the structures, including the mouth and nose, are smaller, they are obstructed more easily by small objects, blood, fluids or swelling. It is important to pay special attention to a child or an infant to make sure the airway stays open.",
        "ANATOMICAL DIFFERENCES IN CHILDREN AND INFANTS AS COMPARED WITH ADULTS": "Structures are smaller. Mouth and nose are more easily obstructed by small objects, blood or swelling. Primarily breathe through nose (especially infants). Airway is more easily blocked. Tongue takes up proportionately more space in the pharynx, which can block the airway more easily. Presence of 'baby teeth'\u2014teeth can be dislodged and enter airway. Face shape and nose are flatter, making it difficult to obtain a good seal of airway with resuscitation mask. Trachea is narrower, softer and more flexible\u2014can close off if the head is tipped back too far or allowed to fall forward. Children and infants have more secretions, which can block the airway. They use abdominal muscles to breathe, making it more difficult to assess breathing. Chest wall is softer, and they tend to rely more on the diaphragm for breathing. More flexible ribs mean lungs are more susceptible to damage, and injuries may not be as obvious. They breathe faster and can fatigue more quickly, leading to respiratory distress.",
        "CRITICAL FACTS 1": "Bones connect to each other at joints and are held together by ligaments. All joints have a normal range of motion, but some are immovable or allow only slight movement. In a healthy person, respiration delivers oxygen the body needs. If that oxygen supply is cut off, brain cells will begin to die in about 4 to 6 minutes. External respiration, or ventilation, is the mechanical process of moving air in and out of the lungs to exchange oxygen and carbon dioxide between body tissues and the environment. It is primarily influenced by changes in pressure inside the chest that cause air to flow into or out of the lungs.",
        "Physiology of the Respiratory System": "External respiration, or ventilation, is the mechanical process of moving air in and out of the lungs to exchange oxygen and carbon dioxide between body tissues and the environment. It is primarily influenced by changes in pressure inside the chest that cause air to flow into or out of the lungs. The body\u2019s chemical controls of breathing are dependent on the level of carbon dioxide in the blood. If carbon dioxide levels increase, the respiration rate increases automatically so that twice the amount of air is taken in until the carbon dioxide is eliminated. It is not the lack of oxygen but the excess carbon dioxide that causes this increase in respiratory rate. Hyperventilation may result from this condition. Internal respiration, or cellular respiration, refers to respiration at the cellular level. These metabolic processes at the cellular level, either within the cell or across the cell membrane, are carried out to obtain energy. This occurs by reacting oxygen with glucose to produce water, carbon dioxide and ATP (energy).",
        "Structures That Support Ventilation": "During inspiration, the thoracic muscles contract, and this moves the ribs outward and upward. At the same time, the diaphragm contracts and pushes down, allowing the chest cavity to expand and the lungs to fill with air. The intercostal muscles, the muscles between the ribs, then contract. During expiration (breathing out), the opposite occurs: the chest wall muscles relax, the ribs move inward, and the diaphragm relaxes and moves up. This compresses the lungs, causing the air to flow out. Accessory muscles are secondary muscles of ventilation only used when breathing requires increased effort. Limited use can occur during normal strenuous activity, such as exercising, but pronounced use of accessory muscles signals respiratory disease or distress. These muscles include the spinal and neck muscles. The abdominal muscles may also be used for more forceful exhalations. Use of abdominal muscles represents abnormal or labored breathing and is a sign of respiratory distress.",
        "Vascular Structures That Support Respiration": "Oxygen and carbon dioxide are exchanged in the lungs through the walls of the alveoli and capillaries. In this exchange, oxygen-rich air enters the alveoli during each inspiration and passes through the capillary walls into the bloodstream. On each exhalation, carbon dioxide and other waste gases pass through the capillary walls into the alveoli to be exhaled.",
        "The Circulatory System": "The circulatory system consists of the heart, blood vessels and blood. It is responsible for delivering oxygen, nutrients and other essential chemical elements to the body\u2019s tissue cells and removing carbon dioxide and other waste products via the bloodstream.",
        "CRITICAL FACTS 2": "The circulatory system consists of the heart, blood vessels and blood. It is responsible for delivering oxygen, nutrients and other essential chemical elements to the body\u2019s tissue cells and removing carbon dioxide and other waste products via the bloodstream.",
        "Anatomy of the Circulatory System": "The heart is a highly efficient, muscular organ that pumps blood through the body. It is about the size of a closed fist and is found in the thoracic cavity, between the two lungs, behind the sternum and slightly to the left of the midline. The heart is divided into four chambers: right and left upper chambers called atria, and right and left lower chambers called ventricles. The right atrium receives oxygen-depleted blood from the veins of the body and, through valves, delivers it to the right ventricle, which in turn pumps the blood to the lungs for oxygenation. The left atrium receives this oxygen-rich blood from the lungs and delivers it to the left ventricle, to be pumped to the body through the arteries. There are arteries throughout the body, including the blood vessels that supply the heart itself, which are the coronary arteries. There are four main components of blood: red blood cells, white blood cells, platelets and plasma. The red blood cells carry oxygen to the cells of the body and take carbon dioxide away. This is carried out by hemoglobin, on the surface of the cells. Red blood cells give blood its red color. White blood cells are part of the body\u2019s immune system and help to defend the body against infection. There are several types of white blood cells. Platelets are a solid component of blood used by the body to form blood clots when there is bleeding. Plasma is the straw-colored or clear liquid component of blood that carries the blood cells and nutrients to the tissues, as well as waste products away to the organs involved in excretion. There are different types of blood vessels that serve different purposes: arteries, veins and capillaries. Arteries carry blood away from the heart, mostly oxygenated blood. The exception is the arteries that carry blood to the lungs for oxygenation, the pulmonary arteries. The aorta is the major artery that leaves the heart. It supplies all other arteries with blood. As arteries travel further from the heart, they branch into increasingly smaller vessels called arterioles. These narrow vessels carry blood from the arteries into capillaries. The venous system includes veins and venules. Veins carry deoxygenated blood back to the heart. The one exception is the pulmonary veins, which carry oxygenated blood away from the lungs. The superior and inferior vena cavae are the large veins that carry the oxygen-depleted blood back into the heart. Like arteries, veins also branch into smaller vessels the further away they are from the heart. Venules are the smallest branches and are connected to capillaries. Unlike arterial blood, which is moved through the arteries by pressure from the pumping of the heart, veins have valves that prevent blood from flowing backward and help move it through the blood vessels. Capillaries are the tiny blood vessels that connect the systems of arteries and veins. Capillary walls allow for the exchange of gases, nutrients and waste products between the two systems. In the lungs, there is exchange of carbon dioxide and oxygen in the pulmonary capillaries. Throughout the body, there is exchange of gases and nutrients and waste at the cellular level. There are three different types of blood vessels: arteries, veins and capillaries. Arteries carry mostly oxygenated blood away from the heart. Veins carry deoxygenated blood back to the heart. Capillaries are the tiny blood vessels that connect the systems of arteries and veins.",
        "Physiology of the Circulatory System": "As the heart pumps blood from the left ventricle to the body, this causes a wave of pressure we refer to as the pulse. We can feel this pulse at several points throughout the body. These \u201cpulse points\u201d occur where the arteries are close to the surface of the skin, and over a bone (e.g., carotid pulse point in the neck, brachial pulse point on the inside of the upper arm). As the blood flows through the arteries, it exerts a certain force that we call blood pressure (BP). BP is described using two measures, the systolic pressure (when the left ventricle contracts) and the diastolic pressure (when the left ventricle is at rest). Oxygen and nutrients are delivered to cells throughout the body, and carbon dioxide and other wastes are taken away, all through the delivery of blood. This continuous process is called perfusion. The primary gases exchanged in perfusion are oxygen and carbon dioxide. All cells require oxygen to function. Most of the oxygen is transported to the cells attached to the hemoglobin, but a tiny amount is also dissolved in the liquid component of the blood, the plasma. The major waste product in the blood, carbon dioxide, is transported mostly in the blood as bicarbonate and transported by the hemoglobin molecule. A tiny amount of carbon dioxide is dissolved in the plasma.",
        "The Nervous System": "The nervous system is the most complex and delicate of all the body systems. The center of the nervous system, the brain, is the master organ of the body and regulates all body functions. The primary functions of the brain are the sensory functions, motor functions and the integrated functions of consciousness, memory, emotions and use of language.",
        "Blood Clotting": "One of blood\u2019s characteristics is its ability to clot. Normally, blood flows freely though the blood vessels but if there is any trauma, blood must be capable of clotting so that bleeding will stop. The clotting mechanism is made up of platelets and the thrombin system. Platelets are small cell fragments made in the bone marrow that become sticky when bleeding occurs. They adhere to the blood vessel wall at the site of bleeding. The thrombin system is made up of several proteins that use chemical reactions to create fibrin. The fibrin clumps and, together with the platelets, forms the clot.",
        "Anatomy of the Nervous System": "The nervous system can be divided into two main anatomical systems: the central nervous system and the peripheral nervous system. The central nervous system consists of the brain and spinal cord. Both are encased in bone (the brain within the cranium and the spinal cord within the spinal column), are covered in several protective layers called meninges and are surrounded by cerebrospinal fluid. The primary functions of the brain are the sensory functions, the motor functions and the integrated functions of consciousness, memory, emotions and use of language. The nervous system is divided into two functional systems. The voluntary system controls movement of the muscles and sensation from the sensory organs. The autonomic system controls the involuntary muscles of the organs and glands. The skin is the largest organ in the human body. It protects against injury and pathogens, regulates fluid balance and body temperature, produces vitamin D and stores minerals.",
        "CRITICAL FACTS 3": "The brain itself can be further subdivided into the cerebrum, the largest and outermost structure; the cerebellum, also called \u201cthe small brain,\u201d which is responsible for coordinating movement; and the brainstem, which joins the rest of the brain with the spinal cord. The brainstem is the control center for several vital functions including respiration, cardiac function and vasomotor control (dilation and constriction of the blood vessels), and is the place of origin for most of the cranial nerves.",
        "Physiology of the Nervous System": "The nervous system can also be divided into two functional systems, the voluntary and autonomic systems. The voluntary system controls movement of the muscles and sensation from the sensory organs. The autonomic system is involuntary, and controls the involuntary muscles of the organs and glands. It can be divided into two systems: the sympathetic and parasympathetic systems. The sympathetic system controls the body\u2019s response to stressors such as pain, fear or a sudden loss of blood. These actions are sometimes referred to as the \u201cfight-or-flight\u201d response. The parasympathetic system works in balance with the sympathetic system, by controlling the body\u2019s return to a normal state.",
        "The Integumentary System": "The integumentary system consists of the skin, hair, nails, sweat glands and oil glands. The skin separates our tissues, organs and other systems from the outside world. The skin is the body\u2019s largest organ. It has three major layers, each consisting of other layers. The epidermis, or outer layer, contains the skin\u2019s pigmentation, or melanin. The dermis, or second layer, contains the blood vessels that supply the skin, hair, glands and nerves, and is what contributes to the skin\u2019s elasticity and strength. The deepest layer, the subcutaneous layer, is made up of fatty tissue and may be of varying thicknesses depending on its positioning on the body. The skin serves to protect the body from injury and from invasion by bacteria and other disease-producing pathogens. It helps regulate fluid balance and body temperature. The skin also produces vitamin D and stores minerals. Blood supplies the skin with nutrients and helps provide its color. When blood vessels dilate (become wider), the blood circulates close to the skin\u2019s surface, making some people\u2019s skin appear flushed or red and making the skin feel warm. Reddening or flushing may not appear in darker skin tones. When blood vessels constrict (become narrower), not as much blood is close to the skin\u2019s surface, causing the skin to appear pale or ashen, and feel cool. This pallor can be found on the palms of the hands of people with darker skin tones.",
        "CRITICAL FACTS 4": "One of the critical functions controlled by the body\u2019s endocrine system is the control of blood glucose levels. The sympathetic nervous system is also regulated through the endocrine system.",
        "The Endocrine System": "The endocrine system is one of the body\u2019s regulatory systems and is made up of ductless glands. These glands secrete hormones, which are chemical substances that enter the bloodstream and influence activity in different parts of the body (e.g., strength, stature, hair growth and behavior).",
        "Anatomy of the Endocrine System": "There are several important glands within the body. The hypothalamus and pituitary glands are in the brain. The pituitary gland, also referred to as the \u201cmaster gland,\u201d regulates growth as well as many other glands. The hypothalamus secretes hormones that act on the pituitary gland. The thyroid gland is in the anterior neck and regulates metabolism, growth and development. It also regulates nervous system activity. The adrenal glands are located on the top of the kidneys and secrete several hormones, including epinephrine (adrenalin) and norepinephrine (noradrenaline). The gonads (ovaries and testes) produce hormones that control reproduction and sex characteristics. The pineal gland is a tiny gland in the brain that helps regulate wake/sleep patterns.",
        "Physiology of the Endocrine System": "One of the critical functions controlled by the body\u2019s endocrine system is the control of blood glucose levels. The Islets of Langerhans, located in the pancreas, make and secrete insulin, which controls the level of glucose in the blood and permits cells to use glucose and glucagon (a pancreatic hormone), which raises the level of glucose in the blood. The sympathetic nervous system is also regulated through the endocrine system. Adrenaline and noradrenaline, produced by the adrenal glands, cause multiple effects on the sympathetic nervous system. Effects include vasoconstriction (constricting of vessels), increased heart rate and dilation of smooth muscles, including those that control respiration. The adrenal glands and pituitary gland are also involved in kidney function and regulate water, sodium chloride and potassium balance. The body works to keep water and levels of electrolytes in the body in balance.",
        "CRITICAL FACTS 5": "The digestive system, or gastrointestinal system, consists of the organs that work together to break down food, absorb nutrients and eliminate waste.",
        "The Digestive System": "The digestive system, or gastrointestinal system, consists of the organs that work together to break down food, absorb nutrients and eliminate waste. It is composed of the alimentary tract Food enters the digestive system through the mouth and then the esophagus, the passageway to the stomach. The stomach and other major organs involved in this system are contained in the abdominal cavity. The stomach is the major organ of the digestive system, and the location where the majority of digestion, or breaking down, takes place. Food travels from the stomach into the small intestine, where further digestion takes place and nutrients are absorbed. The hepatic portal system collects blood from the small intestine and transfers its nutrients and toxins to the liver for absorption and processing before continuing on to the heart. Waste products pass into the large intestine, or colon, where water is absorbed and the remaining waste is passed through the rectum and anus. The liver is the largest solid organ in the abdomen and aids in the digestion of fat through the production of bile, among other processes. The gallbladder serves to store the bile. The pancreas secretes pancreatic juices that aid in the digestion of fats, starches and proteins. It is also the location of the Islets of Langerhans, where insulin and glucagon are produced. Digestion occurs both mechanically and chemically. Mechanical digestion refers to the breaking down of food that begins with chewing, swallowing and moving the food through the alimentary tract, and ends in defecation. Chemical digestion refers to the chemical process involved when enzymes break foods down into components the body can absorb, such as fatty acids and amino acids.",
        "The Urinary System": "Part of the genitourinary system, the urinary system consists of organs involved in the elimination of waste products that are filtered and excreted from the blood. It consists of the kidneys, ureters, urethra and urinary bladder. The kidneys are located in the lumbar region behind the abdominal cavity just beneath the chest, one on each side. They filter wastes from the circulating blood to form urine. The ureters carry the urine from the kidneys to the bladder. The bladder is a small, muscular sac that stores the urine until it is ready to be excreted. The urethra carries the urine from the bladder and out of the body. The urinary system removes wastes from the circulating blood, thereby filtering it. The system helps the body maintain fluid and electrolyte balance. This is achieved through buffers, which control the pH (amount of acid or alkaline) in the urine.",
        "The Reproductive System": "Part of the genitourinary system, the reproductive system of both men and women includes the organs for sexual reproduction.",
        "Male Reproductive System": "The male reproductive organs are located outside of the pelvis and are more vulnerable to injury than those of the female. They include the testicles, a duct system and the penis. Puberty usually begins between the ages of 10 and 14 and is controlled by hormones secreted by the pituitary gland in the brain. The testes produce sperm and testosterone, the primary male sex hormone. The urethra is part of the urinary system and transports urine from the bladder; it is also part of the reproductive system through which semen is ejaculated. The sperm contributes half the genetic material to an offspring.",
        "Female Reproductive System": "The female reproductive system consists of the ovaries, fallopian tubes, uterus and vagina and is protected by the pelvic bones. Glands in the body, including the hypothalamus and pituitary glands in the brain, and the adrenal glands on the kidneys, interact with the reproductive system by releasing hormones that control and coordinate the development and functioning of the reproductive system. The menstrual cycle is approximately 28 days in length. Approximately midway through the cycle, usually a single egg is released which, if united with a sperm, will attach to the lining of the uterus, beginning pregnancy. The female\u2019s ovum contributes half the genetic material to the characteristics of a fetus.",
        "PUTTING IT ALL TOGETHER": "By having a fundamental understanding of body systems and how they function and interact, coupled with knowledge of basic medical terminology, you will be more likely to accurately identify and describe injuries and illnesses. Each body system plays a vital role in survival. All body systems work together, to help the body maintain a constant healthy state. When the environment changes, body systems adapt to these new conditions. For example, the musculoskeletal system works harder during exercise; the respiratory and circulatory systems must also work harder to meet the body\u2019s increased oxygen demands. Body systems also react to the stresses caused by emotion, injury or illness. Body systems do not work independently. The impact of an injury or a disease is rarely restricted to one body system. For example, a broken bone may result in nerve damage that will impair movement and feeling. Injuries to the ribs can make breathing difficult. If the heart stops beating for any reason, breathing will also stop. In any significant injury or illness, body systems may be seriously affected. This may result in a progressive failure of body systems called shock. Shock results from the inability of the circulatory system to provide oxygenated blood to all parts of the body, especially the vital organs. Generally, the more body systems involved in an emergency, the more serious the emergency. Body systems depend on each other for survival. In serious injury or illness, the body may not be able to keep functioning. In these cases, regardless of your best efforts, the patient may die. Fortunately, basic care is usually all you need to provide support to injured body systems until more advanced care is available. By learning the basic principles of care described in later chapters, you may be able to make the difference between life and death."
    },
    {
        "Introduction": "To be an effective emergency medical responder (EMR), you must understand the basic structure and functions of the human body. This knowledge helps you better understand the specific location of symptoms the patient is experiencing, perform an adequate patient examination, communicate your findings to the other members of the emergency medical team, and provide proper emergency treatment for the patient\u2019s condition. This chapter discusses the human anatomy, the relationships among the eight body systems, and how the body changes as it ages.",
        "Topographic Anatomy": "The anatomic terms used in this section describe the location of injury or pain. You must know the basic anatomic terms for human body parts because all members of the emergency medical team must be able to speak the same language when treating a patient. However, if you cannot remember the proper anatomic term for a certain body location, you can use lay terms. Visualize a person standing, facing you, with arms at the sides and thumbs pointing outward (palms toward you). This is the standard anatomic position; keep it in mind when describing a location on the body.\n\nThe first terms that should be clarified are left and right. These terms always refer to the patient\u2019s left and right, not yours. Anterior means front and posterior means back. The midline refers to an imaginary vertical line drawn from head to toe that divides the body into equal left and right sides. Two other useful terms are medial and lateral. Medial means closer to the midline of the body; lateral means farther from the midline. In this context, the eyes are lateral to the nose.\n\nThe term proximal means close and distal means distant. On the body, proximal means close to the point where an arm or leg is attached. Distal means farther from the point of attachment. For example, if the thigh bone (femur) is broken, the break can be either proximal (the end closer to the hip) or distal (the end farther from the hip).\n\nThe term superior means closer to the head and inferior means closer to the feet. For example, the hips are inferior to the chest and the chest is superior to the hips.",
        "Body Systems": "Body systems work together to perform common functions. By studying these body systems, you will have a better background for understanding and treating illnesses and injuries.",
        "The Respiratory System": "Because airway maintenance is one of the most important skills you will learn as an EMR, the respiratory system is the first body system we will review.\n\nThe respiratory system consists of all the structures of the body that contribute to normal breathing. The function of the respiratory system is to bring oxygen into the body and remove the waste gas, carbon dioxide. The airway consists of the nose (nasopharynx), mouth (oropharynx), throat, larynx (voice box), trachea (windpipe), and the passages within the lungs.\n\nAt the upper end of the larynx is a small flap of tissue called the epiglottis. The epiglottis keeps food from entering the larynx. The larger air passages of the lungs, or bronchi, branch into many narrower passages called bronchioles. The airway ends in tiny air sacs called alveoli. These air sacs are surrounded by tiny blood vessels called capillaries. Oxygen in the inhaled air passes through the thin walls that separate the air sacs from the blood vessels and is absorbed by the blood. Carbon dioxide, a waste product of metabolism, passes from the blood across the same thin walls into the air sacs and is exhaled. This exchange of carbon dioxide for oxygen occurs 12 to 16 times per minute, 24 hours a day, without any conscious effort on your part. The rate of breathing increases when the body needs more oxygen or when it generates additional carbon dioxide Blood transports the inhaled oxygen to all parts of the body through the circulatory system.\n\nAir is inhaled when the diaphragm, a large muscle that forms the bottom of the chest cavity, moves downward and the chest muscles contract to expand the size of the chest. Air is exhaled when these muscles relax, thus decreasing the size of the chest.",
        "Mechanism of breathing": "A. Diaphragm moves downward. B. Diaphragm relaxes.",
        "Special Populations": "Infants and children have somewhat different respiratory systems than adults:\nA child\u2019s airway is smaller and more flexible. When you perform rescue breathing on a child, do not apply as much pressure as for an adult. Because a child\u2019s airway is smaller, it is more easily blocked by a foreign object. Infants can breathe only through their noses. Therefore, if an infant\u2019s nose becomes blocked, the infant will show signs of respiratory distress.",
        "The Circulatory System": "The circulatory system is responsible for pumping and circulating blood through the body through a network of blood vessels. The circulatory system includes the heart, blood, and blood vessels.\n\nAfter blood picks up oxygen from the lungs, it travels to the heart, which pumps it to the rest of the body. The cells of the body absorb oxygen and nutrients from the blood and release waste products (including carbon dioxide), which the blood carries back to the lungs and kidneys for removal. In the lungs, the blood exchanges the carbon dioxide for more oxygen, and the cycle begins again.\n\nThe human heart has four chambers: two on the right side and two on the left side. Each upper chamber is called an atrium. The right atrium receives blood from the veins of the body; the left atrium receives blood from the lungs. The bottom chambers are the right and left ventricles. The right ventricle pumps blood to the lungs; the left ventricle pumps blood throughout the body and is the most muscular chamber of the heart. The four chambers of the heart work together in sequence to pump blood to the lungs and to the rest of the body\n\nOne-way check valves in the heart and the veins allow the blood to flow in only one direction through the circulatory system. The arteries carry blood away from the heart at high pressure and therefore have thick walls. The arteries closest to the heart are quite large (about 1 inch [2 cm] in diameter) but become smaller farther away from the heart.\n\nThree major arteries are the neck (or carotid) artery, the groin (or femoral) artery, and the wrist (or radial) artery. The locations of these arteries are shown in. Because these arteries lie between a bony structure and the skin, they are used as locations to measure the patient\u2019s pulse, or the wave of pressure that is created by the heart as it forces blood into the arteries.\n\nThe capillaries are the smallest vessels in the circulatory system. Some capillaries are so small that only one blood cell at a time can go through them. At the capillary level, oxygen and nutrients pass from the blood cells into the cells of body tissues, and carbon dioxide and other waste products pass from the tissue cells to the blood cells, which then return to the lungs.\n\nVeins are the thin-walled vessels of the circulatory system that carry blood back to the heart.\n\nBlood has several components: plasma, the clear, yellowish fluid part of the blood, red blood cells, white blood cells, and platelets, which are responsible for forming blood clots. Blood gets its red color from the red blood cells that carry oxygen from the lungs to the body tissue and bring carbon dioxide back to the lungs. The white blood cells are known as infection fighters because they devour bacteria and other disease-causing organisms.",
        "The Skeletal System": "The skeletal system consists of bones and connective tissues that protect and support the framework for the body. The three main functions of the skeletal system are to:\n1. Support the body.\n2. Protect vital structures.\n3. Produce red blood cells.\nThe skeletal system is divided into seven areas beginning with the skull.",
        "The Skull": "The bones of the head include the skull and the lower jawbone. The skull consists of many bones fused together to form a hollow sphere that contains and protects the brain. The jawbone is a movable bone that is attached to the skull and completes the structure of the head.",
        "The Spine": "The spine consists of a series of 33 separate bones called vertebrae. The spinal vertebrae are stacked one on top of the other and are held together by muscles, tendons (cords that attach muscle to bone), disks, and ligaments (fibrous bands that connect bone to bone). The spinal cord, a group of nerves that carry messages to and from the brain, passes through the hole in the center of each spinal vertebra. The vertebrae provide excellent protection for the spinal cord. In addition to protecting the spinal cord, the spine is the primary support structure for the entire body. The spine has five sections:\n1. Cervical spine (neck)\n2. Thoracic spine (upper back)\n3. Lumbar spine (lower back)\n4. Sacrum (base of spine)\n5. Coccyx (tailbone)",
        "The Shoulder Girdles": "The shoulder girdles are the bones that connect the arms to the skeleton. Each shoulder girdle supports an arm and consists of the collarbone (clavicle), the shoulder blade (scapula), and the upper arm bone (humerus).",
        "The Upper Extremity": "The upper extremity consists of three major bones. The upper arm has one bone (the humerus) and the forearm has two bones (the ulna and the radius). The radius is located on the thumb side of the arm, or lateral, and the ulna is located on the little-finger or medial side. The wrist and hand are part of the upper extremity and consist of several bones, whose names you do not need to learn at this time. You can consider these bones as one unit for the purposes of emergency medical treatment.",
        "The Rib Cage": "The fifth area of the skeletal system is the rib cage (chest). The twelve sets of ribs protect the heart, lungs, liver, and spleen. All of the ribs attach to the spine. The upper five sets of ribs connect directly to the sternum (breastbone). The ends of the sixth through tenth rib sets are connected to each other and to the sternum by a bridge of cartilage. The eleventh and twelfth rib sets are attached to the spine but are not attached to the sternum in any way; they are called floating ribs.",
        "The sternum": "The sternum is located in the front of the chest. The pointed structure at the bottom of the sternum is called the xiphoid process.",
        "The Pelvis": "The pelvis is a closed bony ring that serves as the link between the body and the lower extremities. It protects the reproductive organs and the other organs located in the lower abdominal cavity.\n\nYou can see that a protective bony structure covers each of the essential organs of the body:\nThe skull protects the brain. The vertebrae protect the spinal cord. The ribs protect the heart and lungs. The pelvis protects the lower abdominal and reproductive organs.",
        "The Lower Extremity": "The lower extremities consist of the thigh and the leg. The thighbone (femur) is the longest and strongest bone in the body. The leg has two bones, the tibia and fibula. The kneecap (patella) is a small, relatively flat bone that protects the front of the knee joint. Like the wrist and hand, the ankle and foot contain a large number of smaller bones that you can consider as one unit.",
        "Words of Wisdom": "When you describe the location of an injury or pain, it is more important that other EMS personnel clearly understand the site of the injury or pain than it is that you use exact anatomic terminology. Use the proper names when you can, but strive for accuracy over proper terminology.",
        "Joints": "At the point where two bones come in contact, a joint is formed. Supporting tissues called tendons and ligaments help to hold the joint together. Joints are lubricated by a thin fluid that is contained in a sac surrounding the joint. There are three main types of joints. Fused joints do not permit any movement between the bone ends. The skull is an example of a fused joint. Hinge joints allow movement in one plane. The knee, elbow, and fingers are examples of hinge joints. Ball-and-socket joints allow movement in more than one plane. The shoulder and the hip are examples of ball-and-socket joints.\n\nMoveable joints are designed to permit a certain amount of movement. If movement occurs beyond these limits, injury and damage to the joint will occur",
        "Different types of joints.": "A. The shoulder is a ball-and-socket joint. B. The elbow joints are hinge joints, which allow motion only in one plane.",
        "The Muscular System": "The body contains three different types of muscles: skeletal, smooth, and cardiac. Skeletal muscle provides both support and movement. This muscle is attached to bone by tendons. This muscle causes movement by alternately contracting (shortening) and relaxing (lengthening). To move bones, skeletal muscles are usually paired in opposition: as one member of the pair contracts, the other relaxes. This mechanical opposition enables you to open and close your hand, turn your head, and bend and straighten your elbow. For example, when the biceps relaxes, an opposing muscle on the back of the arm contracts, straightening the elbow. Because skeletal muscles are under direct voluntary control of the brain and can be stimulated to contract or relax at will, they are also called voluntary muscle. Smooth muscle carries out many of the automatic functions of the body, such as propelling food through the digestive system. You have no control over smooth muscle, so it is called involuntary muscle. Cardiac muscle is found only in the heart, so this muscle is constantly working. It has a rich blood supply and can live only a few minutes without an adequate supply of oxygen. The skeletal and muscular systems function together. The two systems combined are referred to as the musculoskeletal system.",
        "The Nervous System": "The nervous system governs the body\u2019s functioning. The nervous system consists of the brain, the spinal cord, and the individual nerves that extend throughout the body. The brain and spinal cord are called the central nervous system. The cables of nerve fibers outside the central nervous system are called the peripheral nervous system.\n\nThe brain is the body\u2019s central computer. It controls the functions of thinking, voluntary actions (things you do consciously), and involuntary (automatic) functions such as breathing, heartbeat, and digestion.\n\nThe spinal cord is a long, tube-like structure that extends from the base of the brain. It consists of a complex network of nerves that make up a two-way communication system between the brain and the rest of the body. Nerves branch out from the spinal cord to every part of the body. Some nerves send signals to the brain about the body\u2014for example, whether it is feeling heat, cold, pain, or pleasure. Other nerves carry signals to muscles that cause the body to move in response to the sensory signals it has received. Without the nervous system, you would not have these sensations, nor would you be able to control the movement of your muscles.",
        "The Digestive System": "The digestive system processes and breaks down food. It also absorbs the food\u2019s nutrients and carries them by the circulatory system to the cells of the body. Food that is not used is eliminated as solid waste from the body.\n\nThe major organs of the digestive system are located in the abdomen. The digestive tract is about 35 feet (11 m) long. It begins at the mouth and continues through the throat, esophagus (tube through which food passes), stomach, small intestine, large intestine, rectum, and anus. Besides digestive tract, the digestive system also includes the liver, gallbladder, and pancreas.\n\nThe liver performs several digestive functions, including the production of bile.\nBile is stored in the gallbladder and released into the small intestine to help digest fats.\n\nThe pancreas also has several digestive functions. Probably its best-known function is the production of insulin. Insulin is released directly into the bloodstream and aids the body in its use of glucose. Diabetes mellitus is caused when insulin production is disrupted.",
        "The Genitourinary System": "The genitourinary system includes the reproductive organs and the urinary system. It is responsible for sexual reproduction functions and for the removal of waste products from the bloodstream. The major organs of the male reproductive system are the testes, which produce sperm, and the penis, which delivers sperm to fertilize the female egg. The major organs of the female reproductive system are the ovaries, which produce eggs, and the uterus, which holds the fertilized egg as it develops during pregnancy. The egg released by the ovaries travels to the uterus through the fallopian tubes. The external opening of the female reproductive system is called the birth canal (vagina). The removal of waste products by the genitourinary system begins in the kidneys, which filter the blood to form urine. The urine flows down from the kidneys through tubes (ureters) into the bladder. The bladder collects and stores the urine before it passes out of the body through the urethra.",
        "Skin": "Skin is the largest organ of the body. Skin covers all parts of the body and has three major functions: Protects against harmful substances in the environment, Regulates body temperature, Transmits information from the outside environment to the brain \n\n Figure 6-15 identifies the layers of the skin. The dermis is the deeper or inner layer of the skin. The prefix epi means upon. Therefore the epidermis is the outer layer of skin that is located upon the dermis.\nSkin protects the body from the environment. Because skin provides an intact layer of cells that serves as a barrier to most foreign substances, it prevents harmful materials from getting into the body. The skin is an effective barrier to bacteria and viruses as long as it is not broken by injury\nSkin regulates the internal temperature of the body. If the body gets too hot, the small blood vessels close to the skin open up (dilate) and bring more body heat to the surface of the skin, where the heat is transferred to the air. Another source of cooling occurs when sweat released by the skin evaporates on the skin\u2019s surface. If the body becomes cold, the blood vessels near the skin surface constrict, transferring more body heat to the inside or core part of the body. Skin receives information from the environment. The skin can perceive touch, pressure, and pain, and it can sense degrees of heat or cold. These perceptions are picked up by special sensors in the skin and transmitted through the nerves and the spinal cord to the brain. The brain serves as the computer to interpret these sensations.",
        "Voices of Experience": "As a young EMS provider eager to save the world, my first reaction was one of disappointment\u2014he was only shot in the leg. In 1982, when I completed my first responder course (now EMR), we did not learn a great deal about the human body. What we did learn, I thought was too much. I remember saying to a classmate, 'Why do we have to learn all this stuff about the body? Who cares?' I only wanted to learn about how to fix the blood and gut injuries. Not long after completing the course, my fire department was dispatched to a person who had been shot, and I then realized that everything I had learned about the human body was worth every minute of class time. We arrived to find a 20-something-year-old man on the ground, in a left lateral recumbent position. The patient was awake and alert, complaining of being shot in the leg. As a young EMS provider eager to save the world, my first reaction was one of disappointment\u2014he was only shot in the leg disappointment\u2014he was only shot in the leg. We completed our primary assessment and proceeded to our secondary assessment after we confirmed there were no obvious life threats. We were taught to look for entrance wounds and exit wounds when there was a penetrating injury. Our assessment revealed only an entrance wound behind (posterior) his left upper leg. We thought, \u201cHey, no big deal,\u201d except that this patient was quickly deteriorating and began to complain of left shoulder pain. I remembered my instructor telling us that a gunshot entry wound without an exit wound means the bullet can be anywhere. Now we were thinking about the possible path of travel this bullet took and what organs might be affected. From its entrance point, we determined that the popliteal, femoral, or iliac artery may be damaged. If the bullet took an upward path, any organ in the abdominal cavity\u2014especially the left lower and left upper quadrants\u2014could be affected, yet the abdomen was soft and non-tender during the assessment. I remembered the diaphragm separated the abdominal and thoracic cavity, so the chest was our next thought. This patient was quickly becoming pale, his pulse was increasing, and his mental state was altered; all signs of shock (hypoperfusion). We decided the bullet could have injured the heart itself, the great vessels (aorta and vena cava), or the lungs. His breathing was rapid but he had equal chest rise. Because we were unable to locate exactly what was affected, but we concluded that the patient was seriously injured, we placed him supine (flat on his back) on a long backboard and packaged him for transport as soon as the ambulance arrived. While awaiting the ambulance, we administered oxygen and maintained the patient\u2019s body temperature. When the ambulance arrived, they were able to leave immediately after our handoff report. We later learned that the bullet had nicked the pericardial sac that surrounds the heart. The patient was taken into surgery and survived. Our knowledge of the human body, as little as it was, allowed us to quickly realize what the potential injuries might be and prepare this patient for immediate transport",
        "Stages of Life\u2014Growth and Development": "The moment after birth, the body begins an ever-changing journey. As a person grows and develops, the body changes from being a tiny, fragile, totally dependent infant to a full-grown, independent adult. As the body then progresses through the natural aging process from adulthood to old age, there is a gradual decline in the functioning of all body systems. Throughout a person\u2019s life, the body constantly changes. You need to know how these changes affect the treatment of your patients. In an infant, the airway is very small and is easily obstructed by swelling or foreign bodies. At birth, infants can breathe only through their noses. Therefore, make sure their noses are not obstructed. Infants experience rapid heat loss, so keep them warm. Toddlers (aged 1 to 3 years) are unsteady and prone to explore. Their poor coordination and balance put them at a high risk for injuries from falls. School-aged children (6 to 12 years) lose their primary teeth, which are then replaced with permanent teeth. They are physically active and prone to injuries from bicycle riding and other athletic mishaps. Adolescents (13 to 18 years) test the limits of authority. They see themselves as invincible and do not fully understand the consequences of dangerous actions. During this period, most adolescents get their driving licenses. Inexperience and risk taking lead to higher incidences of motor vehicle crashes for young drivers. Early adulthood (20 to 40 years) is the period when most body systems are fully developed. Most people enjoy good health during this period. Lifestyle issues such as drinking excess amounts of alcohol and drug abuse contribute to a higher incidence of injuries and illness. Middle adulthood (41 to 60 years) is generally the time when body systems start to decline. Vision and hearing become less acute. Cardiovascular and respiratory systems start to weaken. \nThe incidence of a variety of cancers increases during this period. Women experience menopause during their late 40s and early 50s. Weight control becomes more difficult for most people during this period. During older adulthood (61 and older), the declines that started in middle adulthood become more pronounced. Respiratory and circulatory systems decline further. Most people in this age group experience some loss of bone strength, which makes them more prone to fractures. Many older people experience decreased sensation to heat and cold. Because of this, people in this age group are more prone to sustain burns. Many older adults have poor balance and decreased muscle tone. These factors contribute to a higher incidence of falls. The incidence of mental decline and senility increases in this age group. Normal physiologic changes throughout a person\u2019s life result in an increased occurrence of certain illnesses and injuries at certain stages of life. By understanding these changes, you will be better prepared to provide quality care for your patients.",
        "Table 6-1 Typical Vital Sign Values Based on Age": "**Table 6-1: Typical Vital Sign Values Based on Age** \n\n- **Infants (newborn to age 1 year):**  Pulse Rate: 90\u2013180 beats/min  \nRespirations: 25\u201360 breaths/min  \nSystolic Blood Pressure: 50\u201395 mm Hg\n\n- **Children (ages 1 to 12 years):**  \nPulse Rate: 70\u2013150 beats/min  \n  Respirations: 15\u201330 breaths/min  \nSystolic Blood Pressure: 80\u2013110 mm Hg\n\n- **Adults:**  \nPulse Rate: 60\u2013100 beats/min  Respirations: 12\u201320 breaths/min  \nSystolic Blood Pressure: 90\u2013140 mm Hg",
        "Vital Signs": "Measuring a patient\u2019s vital signs allows you to evaluate a variety of bodily functions. The most commonly measured vital signs are pulse (heart rate), respiration rate, and blood pressure. As an EMR, it is important for you to understand how to measure these vital signs. This skill will be covered in Chapter 9, Patient Assessment. It is also important for you to know the normal values for vital signs for infants (newborn to age 1 year), children (ages 1 to 12 years), and adults. The normal range of these vital signs is shown in Table 6-1.\n\nNormal vital signs change with age. The normal pulse rate decreases with age. The normal pulse rate for infants is 90 to 180 beats/min. This rate drops to 60 to 100 beats/min for adults. Respiratory rates also decrease with age. The normal respiratory rate for infants is 25 to 60 breaths/min. This rate drops to 12 to 20 breaths/min for adults. The values for systolic blood pressure increase with age. The normal systolic blood pressure for infants is 50 mm Hg to 95 mm Hg. In adults, the blood pressure increases to 90 mm Hg to 140 mm Hg.\n\nSignificant variation in normal vital sign values exists within any age group. These variations are dependent on a person\u2019s size, his or her degree of physical conditioning, and the medications he or she takes. For example, the normal pulse rate for young adults is 60 to 100 beats/min. However, a long-distance runner or a competitive bicyclist in this age group may have a resting heart rate of 45 beats/min. A person of the same age who is out of shape and overweight may have a resting heart rate of 82 beats/min. Each of these values is normal for that person in his or her condition. Many factors can influence vital signs. Some factors increase certain vital signs and others decrease them.",
        "Factors That Can Change Certain Vital Signs": "**Table 6-2: Factors That Can Change Certain Vital Signs**\n\nSeveral factors can influence pulse rate, respirations, and systolic blood pressure. Those that may **increase** these vital signs include **exercise, fever, illness, pain, stress, excess body weight**, and the **abuse of illegal drugs**. Conversely, factors that may **decrease** these vital signs include **athletic conditioning, blood pressure medications**, and also the **abuse of illegal drugs**.",
        "Words of Wisdom_0": "Because it may be hard to remember the normal ranges of vital signs for each age group, many EMS agencies keep a list of these values available electronically or in their life support kits so their personnel can quickly refer to them when needed",
        "Prep Kit-Ready for Review": "You need to know basic anatomic terms to understand the location of a patient\u2019s specific signs or symptoms and to better communicate with all members of the emergency medical team.\nYou need to know basic anatomic terms to understand the location of a patient\u2019s specific signs or symptoms and to better communicate with all members of the emergency medical team.\nThe respiratory system consists of the lungs and the airway. This system functions to take in air through the airway and transport it to the lungs. In the lungs, red blood cells absorb the oxygen and release carbon dioxide so it can be expelled from the body.\nThe respiratory system consists of the lungs and the airway. This system functions to take in air through the airway and transport it to the lungs. In the lungs, red blood cells absorb the oxygen and release carbon dioxide so it can be expelled from the body.\nThe circulatory system consists of the heart (the pump), the blood vessels (the pipes), and blood (the fluid). Its role is to transport oxygenated blood to all parts of the body and to remove waste products, including carbon dioxide. \nThe circulatory system consists of the heart (the pump), the blood vessels (the pipes), and blood (the fluid). Its role is to transport oxygenated blood to all parts of the body and to remove waste products, including carbon dioxide.\nThe skeletal system consists of the bones of the body. These bones function to provide support, to protect vital structures, and to produce red blood cells.\nThe skeletal system consists of the bones of the body. These bones function to provide support, to protect vital structures, and to produce red blood cells.\nThe muscular system consists of three kinds of muscles: voluntary (skeletal) muscle, smooth (involuntary) muscle, and cardiac (heart) muscle. Muscles provide both support and movement. The skeletal system works\nThe muscular system consists of three kinds of muscles: voluntary (skeletal) muscle, smooth (involuntary) muscle, and cardiac (heart) muscle. Muscles provide both support and movement. The skeletal system works\nThe muscular system to provide motion. These two systems together are called the musculoskeletal system.\nThe nervous system consists of the brain, the spinal cord, and individual nerves. The brain serves as the central computer, and the nerves transmit messages between the brain and the body.\n\nThe digestive system consists of the mouth, esophagus, stomach, intestines, liver, gallbladder, and pancreas. This system breaks down usable food for use by the body and eliminates solid waste.\n\nThe genitourinary system consists of the organs of reproduction together with the organs involved in the production and excretion of urine.\n\nSkin covers the entire body. It protects the body from the environment, regulates the internal temperature of the body, and transmits sensations from the skin to the nervous system.\n\nYou need a basic understanding of the body systems to treat the illnesses and injuries you will encounter as an emergency medical responder.\n\nAn understanding of some of the changes that occur at different stages within the life cycle helps you to better treat the wide variety of patients you will encounter.\n\nVital signs change at different stages of the life cycle. It is important for you to understand these changes so you understand the values you encounter in patients.",
        "Vital Vocabulary": "anterior: The front surface of the body., carbon dioxide: The gas formed as a waste product of metabolism and excreted through the respiratory system during exhalation., cartilage: A tough, elastic form of connective tissue that covers the ends of most bones to form joints; also found in some specific areas such as the nose and the ears., cervical spine: That section of the spinal column consisting of the seven vertebrae located in the neck., circulatory system: The heart and blood vessels, which together are responsible for the continuous flow of blood throughout the body., coccyx: The tailbone; the small bone at the base of the spinal column., diaphragm: A muscular dome that separates the chest from the abdominal cavity. Contraction of the diaphragm and the chest wall muscles brings air into the lungs; relaxation expels air from the lungs., digestive system: The gastrointestinal tract (stomach and intestines), mouth, salivary glands, pharynx, esophagus, liver, gallbladder, pancreas, rectum, and anus, which together are responsible for the absorption of food and the elimination of solid waste from the body., distal: Describing structures that are farther from the trunk (or torso) or nearer to the free end of an extremity. Opposite of proximal., epiglottis: The valve located at the upper end of the voice box that prevents food from entering the larynx., floating ribs: The eleventh and twelfth ribs, which do not connect to the sternum., genitourinary system: The organs of reproduction, together with the organs involved in the production and excretion of urine., humerus: The upper arm bone., inferior: Nearer to the feet than the head., insulin: A hormone produced by the pancreas that enables glucose in the blood to be used by the cells of the body; supplementary insulin is used in the treatment and control of diabetes mellitus., joint: The point where two bones come into contact., larynx: A structure composed of cartilage in the neck that guards the entrance to the windpipe and functions as the organ of voice; also called the voice box., lateral: Away from the midline of the body., ligaments: Fibrous bands that connect bones to bones and support and strengthen joints., lumbar spine: The lower part of the back formed by the lowest five nonfused vertebrae., medial: Closer to the midline of the body., midline: An imaginary vertical line drawn from the head to toe that divides the body into equal left and right sides., nerves: Fiber tracts or pathways that carry messages from the spinal cord and brain to all body parts and back; sensory, motor, or a combination of both., nervous system: The brain, spinal cord, and nerves., pelvis: The closed bony ring, consisting of the sacrum and the pelvic bones, that connects the trunk to the lower extremities., plasma: The clear, yellowish fluid of the blood that carries blood cells, transports nutrients, and removes cellular waste materials., platelets: Microscopic disk-shaped elements in the blood that are essential to the formation of a blood clot, the mechanism that stops bleeding., posterior: The back surface of the body., proximal: Closer to the trunk (or torso). Opposite of distal., pulse: The wave of pressure that is created by the heart when it contracts as a result of forcing the blood out and into the major arteries., radius: The bone on the thumb side of the forearm., respiratory system: All body structures that contribute to normal breathing., ribs: The paired arches of bone, 12 on either side, that extend from the thoracic vertebrae toward the anterior midline of the trunk., sacrum: One of three bones (sacrum and two pelvic bones) that makes up the pelvic ring; forms the base of the spine., shoulder girdles: The three bones of the upper extremity; each shoulder supports the clavicle, the scapula, and the humerus., skull: The bones of the head, collectively; the protective structure for the brain., sternum: The breastbone., superior: Closer to the head or above a body part., tendons: Tough, rope-like cords of fibrous tissue that attach muscle to bone., thoracic spine: The 12 vertebrae that attach to the 12 ribs; the upper part of the back., topographic anatomy: The superficial landmarks on the body that serve as location guides to the structures that lie beneath them., ulna: The bone on the little-finger side of the forearm., vertebrae: The 33 bones of the spinal column: 7 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 4 coccygeal vertebrae., xiphoid process: The flexible cartilage at the lower tip of the sternum."
    },
    {
        "National EMS Education Standard Competencies": "Preparatory\nApplies fundamental knowledge of the emergency medical services (EMS) system, safety/well-being of the emergency medical technician (EMT), medical/legal and ethical issues to the provision of emergency care. Anatomy and Physiology\nApplies fundamental knowledge of the anatomy and function of all human systems to the practice of EMS. Pathophysiology\nApplies fundamental knowledge of the pathophysiology of respiration and perfusion to patient assessment and management.",
        "Introduction A working knowledge of anatomy is important.": "Terminology:\nAnatomy\nPhysiology\nPathophysiology",
        "Topographic Anatomy Topographic anatomy applies to a body in the anatomic position.": "Patient stands facing you, arms at side, palms forward.",
        "Imaginary straight lines that divide the body": "Three main areas\nCoronal (frontal) plane: divides the body front/back\nSagittal (lateral) plane: divides the body left/right\nMidsagittal (midline) plane: divides the body into equal left and right halves\nTransverse (axial) plane: divides the body top/bottom FIGURE 6-1 Anatomic planes of the body. \u00a9 Jones & Bartlett Learning.",
        "Cells to Systems Cells: foundation of the human body": "Tissues: cells that share a common function\nOrgans: groups of tissues that perform similar or interrelated jobs\nBody systems: organs with similar function working together",
        "The Skeletal System: Anatomy The skeleton gives us our recognizable human form.": "Composed of 206 bones\nAxial skeleton\nAppendicular skeleton\nPelvis",
        "The Axial Skeleton Foundation to which the arms and legs are attached": "Includes:\nSkull\nFacial bones\nThoracic cage\nVertebral column Skull\nCranium: made up of 4 bones\nFace: made up of 14 bones FIGURE 6-6 The skull. A. Anterior view. B. Inferior view. \u00a9 Jones & Bartlett Learning. Spinal column\nComposed of 33 bones (vertebrae)\nDivided into 5 sections:\nCervical\nThoracic\nLumbar\nSacrum\nCoccyx FIGURE 6-7 The vertebral column is composed of\n33 bones divided into five sections. \u00a9 Jones & Bartlett Learning. Thorax\nFormed by of 12 thoracic vertebrae and 12 pairs of ribs\nThoracic cavity contains:\nHeart\nLungs\nEsophagus\nGreat vessels FIGURE 6-8 The thorax. \u00a9 Jones & Bartlett Learning.",
        "Occur wherever bones come in contact": "Consist of the ends of the bones and the connecting and supporting tissues\nTwo types of joints:\nBall-and-socket joint\nAllows rotation and bending \nHinge joint\nMotion restricted to flexion and extension FIGURE 6-4 The shoulder is an example of a\nball-and-socket joint. FIGURE 6-5 The elbow joints are hinge joints, which allow motion in only one plane (flexion and extension). \u00a9 Jones & Bartlett Learning. \u00a9 Jones & Bartlett Learning.",
        "The Appendicular Skeleton Arms, legs, their connection points, and pelvis": "Includes:\nJoints\nUpper extremities\nPelvis\nLower extremities",
        "Upper Extremities": "Upper extremity extends from pectoral girdle to fingertips\nComposed of arms, forearms, hands, and fingers Shoulder girdle: three bones come together\nClavicle\nScapula\nHumerus FIGURE 6-9 The bones of the shoulder girdle include the\nclavicle and scapula. \u00a9 Jones & Bartlett Learning. Arm\nHumerus is the supporting bone\nForearm consists of the radius and ulna\nRadius on lateral side\nUlna on medial side",
        "Wrist and hand": "Ball-and-socket joint\nPrincipal bones\nCarpals\nMetacarpals\nPhalanges FIGURE 6-10 The major bones in the wrist and hand\ninclude the carpals, the metacarpals, and the phalanges. \u00a9 Jones & Bartlett Learning.",
        "The Pelvis": "The pelvic girdle consists of:\nTwo coxae (hip bones)\nSacrum\nCoccyx\nEach pelvic bone is formed by fusion of the ilium, ischium, and pubis.",
        "Posteriorly, the ilium, ischium, and pubis bones are joined by the sacrum.": "Anteriorly, the pubic symphysis is where the right and left pubis are joined. FIGURE 6-11 The pelvis is a closed, bony ring that consists of the sacrum, ilium, ischium, pubis, acetabulum, and pubic symphysis. \u00a9 Jones & Bartlett Learning.",
        "Lower Extremities": "Femur\nLongest bone in body\nConnects into the acetabulum (pelvic girdle) by a ball-and-socket joint\nThe greater and lesser trochanter are where the major muscles of the thigh connect to the femur. Knee connects the upper leg to the lower leg\nKneecap (patella)\nLower leg\nTibia (shinbone)\nAnterior of leg\nFibula\nLateral side of leg Ankle\nA hinge joint\nAllows flexion/extension of foot",
        "Foot": "Contains 7 tarsal bones\n5 metatarsal bones form substance of foot\nToes are formed by phalanges FIGURE 6-13 A. The surface landmarks of the foot, including the talus, the calcaneus, and the phalanges. B. Soft tissue of the ankle. \u00a9 Jones & Bartlett Learning.",
        "The Skeletal System: Physiology The skeletal system:": "Gives the body its shape\nProtects fragile organs\nAllows for movement\nStores calcium\nHelps create blood cells",
        "The Musculoskeletal System: Anatomy": "Musculoskeletal system provides:\nForm\nUpright posture\nMovement\nProtection of vital internal organs FIGURE 6-15 The major muscle groups. \u00a9 Jones & Bartlett Learning.",
        "Types of muscles:": "Skeletal (voluntary) muscle\nSmooth muscle\nCardiac muscle FIGURE 6-14 The three types of muscle are skeletal,\nsmooth, and cardiac. \u00a9 Jones & Bartlett Learning.",
        "The Musculoskeletal System: Physiology Contraction and relaxation of system make it possible to move and manipulate the environment.": "A by-product of this movement is heat.\nAnother function of the muscles is to protect the structures under them.",
        "The Respiratory System: Anatomy": "The Respiratory System: Anatomy Structures of the body that contribute to respiration (the process of breathing) FIGURE 6-16 The respiratory system consists of all structures of the body that contribute to the process of breathing. \u00a9 Jones & Bartlett Learning.",
        "Upper Airway": "Includes:\nNose\nMouth (oral cavity)\nTongue\nJaw (mandible) \nLarynx\nDivides upper and lower airway Includes: (cont\u2019d)\nPharynx\nNasopharynx\nOropharynx\nLaryngopharynx\nTrachea\nEpiglottis",
        "Lower Airway Thyroid cartilage": "Adam\u2019s apple \nCricoid cartilage: immediately below the thyroid cartilage\nCricothyroid membrane \nTrachea \nEnds at carina, dividing into right and left bronchi leading to bronchioles",
        "The two lungs are held in place by:": "Trachea\nArteries and veins\nPulmonary ligaments\nDivided into two lobes\nRight lung has upper, middle, and lower lobes\nLeft lung has upper and lower lobes Within the lobes are bronchi, bronchioles, and alveoli.\nAllow for gas exchange\nPleura: a layer of smooth, glistening tissue that covers each lung and lines the chest cavity\nBetween the two layers is a small amount of fluid that allows the tissues to glide smoothly. FIGURE 6-17 The lungs contain millions of air sacs (alveoli), which lie at the ends of air passages. Small blood vessels surround the alveoli, allowing for gas exchange. \u00a9 Jones & Bartlett Learning.",
        "Muscles of Breathing Diaphragm is the primary muscles of breathing.": "Also involved are:\nNeck (cervical muscles)\nIntercostal muscles\nAbdominal muscles\nPectoral muscles",
        "Inhalation Diaphragm and intercostal muscles contract": "Pressure in the thoracic cavity decreases\nLungs fill with air\nActive part of the respiratory cycle",
        "Exhalation Diaphragm and intercostal muscles relax": "Thoracic cavity returns to it normal shape and volume\nPassive portion of the respiratory cycle",
        "The Respiratory System: Physiology": "Function is to provide body with oxygen and eliminate carbon dioxide\nVentilation and respiration are two separate, interdependent functions of the respiratory system. Respiration is the exchange of oxygen and carbon dioxide in the alveoli and tissues.\nProvides oxygen to the cells and removes waste carbon dioxide\nDiffusion: passive process in which molecules move from an area of higher concentration to an area of lower concentration Chemical control of breathing\nBrainstem controls breathing by monitoring carbon dioxide in blood and spinal fluid.\nPrimary reason for breathing is to lower carbon dioxide levels.\nHypoxic drive Nervous system control of breathing\nThe medulla initiates ventilation cycles.\nStimulated by high carbon dioxide levels\nThe pons has two areas that help augment respirations during emotional or physical stress. Ventilation is simple air movement into and out of the lungs.\nRequires chest rise and fall\nTidal volume: amount of air moved into or out of the lungs during a single breath\nResidual volume: the gas that remains in the lungs to keep the lungs open Dead space: the portion of the respiratory system that has no alveoli and where little or no exchange of gas between air and blood occurs\nRespiratory rate \u00d7 tidal volume = minute volume",
        "Characteristics of Normal Breathing Normal rate and depth (tidal volume)": "Regular rhythm or pattern of inhalation and exhalation\nClear, audible breath sounds on both sides of chest\nRegular rise and fall movement on both sides of the chest\nMovement of the abdomen",
        "Inadequate Breathing Patterns in Adults Labored breathing": "Muscle retractions\nPale, cyanotic, cool, damp skin\nTripod position\nAgonal gasps",
        "The Circulatory System: Anatomy": "Complex arrangement of connected tubes\nArteries, arterioles, capillaries, venules, and veins\nTwo circuits\nSystemic circulation (body)\nPulmonary circulation (lungs) FIGURE 6-25 The circulatory system includes the heart, arteries, veins, and interconnecting capillaries. The capillaries are the smallest vessels and connect venules and arterioles. At the center of the system, and providing its driving force, is the heart. Blood circulates through the body under pressure generated by the two sides of the heart. \u00a9 Jones & Bartlett Learning.",
        "Hollow muscular organ": "Made of specialized cardiac muscle \nWorks as two paired pumps\nEach side is divided into:\nAtrium (upper chamber)\nVentricle (lower chamber) Circulation\nThe heart receives its blood from the aorta.\nRight side receives deoxygenated blood from the veins.\nLeft side receives oxygenated blood from the lungs. FIGURE 6-27 A. The right (lower pressure) side of the\nheart pumps blood from the body through the lungs.\nB. The left (higher-pressure) side of the heart pumps\noxygen-rich blood to the rest of the body. \u00a9 Jones & Bartlett Learning. Normal resting heart rate (HR) is 60\u2013100 beats/min.\nStroke volume (SV)\nAmount of blood moved by one beat\nCardiac output (CO)\nAmount of blood moved in 1 minute\nHR \u00d7 SV = CO Electrical conduction system\nSpecialized tissue capable of initiating and conducting electrical current\nCauses smooth, coordinated contractions\nContractions produce pumping action",
        "Arteries carry blood from the heart to all body tissues.": "Aorta branches into:\nCoronary arteries\nCarotid arteries\nHepatic arteries\nRenal arteries\nMesenteric arteries Pulmonary artery\nCarries oxygen-poor blood to the lungs\nArteries branch into smaller arteries and then into arterioles. \nArterioles branch into a series of increasingly smaller vessels until they connect to the capillaries. Pulse\nPalpated most easily at the neck, wrist, or groin\nCreated by forceful pumping of blood out of the left ventricle and into the major arteries FIGURE 6-28 The main arteries supply blood to a vast network of smaller arteries and arterioles. Venules deliver oxygen-poor blood to the veins that return blood to the heart. \u00a9 Jones & Bartlett Learning.",
        "Capillaries Connect arterioles to venules": "Fine end divisions of arterial system\nAllow contact between blood and cells",
        "Veins Return oxygen-depleted blood to the heart": "The superior vena cava carries blood returning from the head, neck, shoulders, and upper extremities.\nThe inferior vena cava carries blood from the abdomen, pelvis, and lower extremities.\nJoin at right atrium",
        "The Spleen Solid organ located under the rib cage": "Filters blood\nParticularly susceptible to injury from blunt trauma",
        "Blood Composition Plasma (liquid)": "Red blood cells (erythrocytes)\nWhite blood cells (leukocytes)\nPlatelets",
        "The Circulatory System: Physiology": "Blood pressure: pressure that blood exerts against the walls of arteries\nSystole: when the left ventricle of the heart contracts, it pumps blood from the ventricle into the aorta.\nDiastole: when the muscle of the ventricle relaxes, the ventricle fills with blood. Blood pressure readings \nSystolic blood pressure: high point of wave\nDiastolic blood pressure: low point of wave",
        "Normal Circulation in Adults Automatically adjusted and controlled": "Perfusion: circulation of blood in organ or tissue in adequate amounts to meet the needs of cells\nHypoperfusion: inadequate blood supply to organs, tissues, and cells",
        "Inadequate Circulation in Adults The system can adjust to small blood loss.": "Vessels constrict.\nThe heart pumps more rapidly.\nWith a large loss, adjustment fails, and the patient goes into shock.\nMean arterial pressure can help detect shock.",
        "Functions of Blood Fighting infection": "Transporting oxygen\nTransporting carbon dioxide\nControlling pH\nTransporting wastes and nutrients\nClotting (coagulation)",
        "Nervous System Control of the Cardiovascular System": "Sympathetic nervous system is responsible for fight-or-flight response.\nSends commands to adrenal glands\nEpinephrine (adrenaline) and norepinephrine (noradrenaline) are secreted to stimulate heart and blood vessels. Blood vessels have alpha-adrenergic receptors.\nThe heart and lungs have beta-adrenergic receptors.\nBaroreceptors sense pressure in the blood vessels.\nThe sympathetic and parasympathetic nervous system balance each other.",
        "The Nervous System: Anatomy and Physiology The nervous system is perhaps the most complex organ in the body.": "Divided into two main portions:\nCentral nervous system (CNS)\nPeripheral nervous system",
        "Central Nervous System": "Brain\nControlling organ of the body\nSubdivisions\nCerebrum\nCerebellum\nBrainstem FIGURE 6-34 The brain lies well protected within the skull. Its major subdivisions are the cerebrum, the cerebellum, and the brainstem. \u00a9 Jones & Bartlett Learning. Cerebrospinal fluid\nCushions and protects the brain and spinal cord\nCirculation in the head\nOxygenated blood is supplied via carotid arteries\nDeoxygenated blood is drained by the internal and external jugular veins Spinal cord\nExtension of the brainstem\nTransmits messages between brain and body FIGURE 6-35 The spinal cord is a continuation of the\nbrainstem. It exits the skull at the foramen magnum and\nextends down to the level of the second lumbar vertebra. \u00a9 Jones & Bartlett Learning.",
        "Divided into two main portions:": "Somatic nervous system\nAutonomic nervous system Somatic nervous system\nTransmits signals from brain to voluntary muscles\nAutonomic nervous system\nInvoluntary actions \nSplit into two areas\nSympathetic nervous system (fight-or-flight)\nParasympathetic nervous system (slows body) Two types of nerves within peripheral nervous system\nSensory nerves carry information from body to CNS.\nMotor nerves carry information from CNS to muscles.",
        "Two layers": "Epidermis (superficial)\nDermis (deeper)\nSubcutaneous tissue lies beneath the skin. \nFat that insulates and serves as energy reservoir",
        "The Integumentary System": "FIGURE 6-36 The layers of the skin can be divided between the epidermis and the dermis. Below the skin is a layer of subcutaneous tissue. \u00a9 Jones & Bartlett Learning.",
        "The skin is the largest single organ in the body.": "Three major functions\nProtects the body in the environment\nRegulates body temperature\nTransmits information from environment to brain The Integumentary System (Skin): Physiology",
        "Gastrointestinal system": "Abdomen: the second major body cavity\nContains major organs of digestion and excretion\nOrganized into 4 quadrants:\nRight upper \nLower upper \nRight lower \nLeft lower",
        "The Digestive System: Anatomy": "FIGURE 6-38  Several of the organs in the\nabdomen lie in more than one quadrant. \u00a9 Jones & Bartlett Learning. Liver\nBile ducts\nSmall intestine\nLarge intestine\nAppendix\nRectum",
        "Mouth": "Lips, cheeks, gums, teeth, tongue\nSalivary glands\nOropharynx\nEsophagus\nStomach\nPancreas",
        "The Digestive System: Physiology Enzymes are added to food.": "By salivary glands, stomach, liver, pancreas, and small intestine\nFood is converted into basic sugars, fatty acids, and amino acids.\nFurther processed by liver\nCirculated via blood throughout body",
        "Elements of the lymphatic system:": "Spleen\nLymph nodes\nLymph\nLymph vessels\nThymus gland\nOther components Supports the circulatory system and immune system\nLymph is a thin, straw-colored fluid that carries oxygen and nutrients to cells and waste products away.\nHelps to rid the body of toxins and other harmful materials",
        "Complex message and control system": "Integrates many body functions\nHormones are released directly into the bloodstream.\nEpinephrine, norepinephrine, insulin",
        "The brain controls the release of hormones.": "Excesses or deficiencies in hormones can cause disease. FIGURE 6-40 The endocrine system controls the\nproduction and release of hormones in the body. \u00a9 Jones & Bartlett Learning.",
        "The Urinary System: Anatomy and Physiology": "Controls the discharge of certain waste materials filtered from the blood by the kidneys\nControls fluid balance in the body\nFilters and eliminates wastes\nControls pH balance",
        "Kidneys": "Ureter\nUrinary bladder FIGURE 6-42 The urinary system lies in the\nretroperitoneal (behind the peritoneum) space behind the\norgans of the digestive system. The urinary system in men\nand women includes the kidneys, ureters, bladder, and\nurethra. This diagram shows the male urinary system. \u00a9 Jones & Bartlett Learning.",
        "The Genital System: Anatomy and Physiology": "Controls reproductive processes\nMale system consists of:\nTesticles\nEpididymis\nVasa deferentia\nProstate gland\nSeminal vesicles\nPenis FIGURE 6-43 The male reproductive system consists of the testicles, epididymis, vasa deferentia, prostate gland, seminal vesicles, and penis. \u00a9 Jones & Bartlett Learning. Female system consists of:\nOvaries\nFallopian tubes\nUterus \nCervix\nVagina FIGURE 6-44 The female reproductive system consists of the ovaries, fallopian tubes, uterus, cervix, and vagina. \u00a9 Jones & Bartlett Learning.",
        "Life Support Chain": "All cells in body require oxygen, nutrients, and removal of waste.\nThe circulatory system is the carrier of these supplies and wastes.\nIf interference occurs, cells become damaged and die. Cells use oxygen to turn nutrients into chemical energy through metabolism.\nAerobic metabolism uses oxygen.\nCells switch to anaerobic metabolism when oxygen is limited. Movement of oxygen, waste, and nutrients occurs by diffusion.\npH is critical to diffusion.\nThe body expends a large amount of energy to maintain normal pH.",
        "Pathophysiology": "The study of functional changes that occur when body reacts to disease\nRespiratory compromise is the inability of the body to move gas effectively. \nHypoxia\nHypercarbia Factors that impair ventilation\nBlocked airway\nImpairment of the muscles of breathing\nAirway obstructed physiologically (asthma)\nOther factors Factors that impair respiration\nChange in atmosphere\nHigh altitudes\nImpaired movement of the gas across cell membrane V/Q ratio\nHow much gas is being moved effectively through the lungs\nHow much blood is flowing around the alveoli where perfusion occurs\nMismatch occurs when one variable is abnormal. Effects of respiratory compromise on the body:\nOxygen levels fall and carbon dioxide levels rise.\nRespiratory rate increases.\nBlood becomes more acidic.\nThe brain sends commands to the body to breathe. \nCells move from aerobic to anaerobic metabolism.",
        "Occurs when organs and tissue do not receive enough oxygen": "Impaired oxygen delivery causes cellular hypoxia.\nCategorized into several types depending on the cause Effects of shock on the body\nThe level of oxygen supplied to the tissues falls.\nCells engage in anaerobic metabolism.\nSevere metabolic acidosis ensues.\nBaroreceptors initiate the release of epinephrine and norepinephrine.\nThe heart rate increases.\nInterstitial fluid moves into the capillaries.",
        "Impairment of Cellular Metabolism Results in the inability to properly use oxygen and glucose at the cellular level": "Cells create energy through anaerobic metabolism.\nCan result in metabolic acidosis\nBrain cells cannot use alternative fuels.\nCellular injury may become irreversible."
    },
    {
        "ac": "adrenal cortex",
        "acth": "adrenocorticotropic hormone",
        "adh": "antidiuretic hormone",
        "cah": "congenital adrenal hyperplasia",
        "di": "diabetes insipidus",
        "dka": "diabetic ketoacidosis",
        "dm": "diabetes mellitus",
        "fsh": "follicle stimulating hormone",
        "gh": "growth hormone",
        "hcg": "human chorionic gonadotropin",
        "hgf": "human growth factor",
        "icsh": "interstitial cell stimulating hormone",
        "iddm": "insulin dependent diabetes mellitus",
        "igt": "impaired glucose tolerance",
        "jod": "juvenile onset diabetes",
        "lf": "luteinizing hormone",
        "mea": "multiple endocrine adenomatosis",
        "men": "multiple endocrine neoplasia",
        "msh": "melanocyte-stimulating hormone",
        "niddm": "noninsulin dependent diabetes mellitus",
        "oxt": "oxytocin",
        "prl": "prolactin",
        "pth": "parathyroid hormone",
        "siadh": "syndrome of inappropriate adh",
        "sth": "somatotropic hormone",
        "t3": "triiodothyronine",
        "t4": "thyroxine",
        "tft": "thyroid function test",
        "tsh": "thyroid stimulating hormone"
    },
    {
        "ab": "abortion",
        "afp": "alpha fetoprotein",
        "arm": "artificial rupture of membranes",
        "art": "assisted reproductive technology",
        "bse": "breast self examination",
        "bso": "bilateral salpingo-oophorectomy",
        "bws": "battered woman syndrome",
        "cs": "cesarean section",
        "cvs": "chorionic villus sampling",
        "cx": "cervix",
        "d&c": "dilation and curettage",
        "d&e": "dilation and evacuation",
        "dub": "dysfunctional uterine bleeding",
        "ecc": "endo-cervical curettage",
        "edc": "estimated date of confinement",
        "edd": "estimated date of delivery",
        "efm": "electronic fetal monitor",
        "ert": "estrogen replacement therapy",
        "fhr": "fetal heart rate",
        "fht": "fetal heart tone",
        "ftnd": "full term normal delivery",
        "gdm": "gestational diabetes mellitus",
        "gift": "gamete intra-fallopian transfer",
        "grav": "pregnancy",
        "gyn": "gynecology",
        "hcg": "human chorionic gonadotropin",
        "hdn": "hemolytic disease of the newborn",
        "hrt": "hormone replacement therapy",
        "hsg": "hysterosalpingography",
        "idm": "infant of diabetic mother",
        "iud": "intrauterine device",
        "iufd": "intrauterine fetal distress",
        "iup": "intrauterine pregnancy",
        "ivf": "in vitro fertilization",
        "l&d": "labor and delivery",
        "ldrp": "labor, delivery, recovery, postpartum",
        "lmp": "late menstrual period",
        "nb": "newborn",
        "nd": "normal delivery",
        "ob": "obstetrics",
        "ob/gyn": "obstetrics and gynecology",
        "ocp": "oral contraceptive pills",
        "pap smear": "papanicolaou smear",
        "para": "number of viable births",
        "pid": "pelvic inflammatory disease",
        "pih": "pregnancy-induced hypertension",
        "pms": "premenstrual syndrome",
        "pou": "placenta, ovary, uterus",
        "sab": "spontaneous abortion",
        "svd": "spontaneous vaginal delivery",
        "tab": "therapeutic abortion",
        "tah": "total abdominal hysterectomy",
        "top": "termination of pregnancy",
        "tss": "toxic shock syndrome",
        "uc": "uterine contractions",
        "vh": "vaginal hysterectomy",
        "zift": "zygote intra-fallopian transfer"
    },
    {
        "abmt": "autologous bone marrow transplant",
        "abo": "blood groups",
        "ac": "anticoagulant",
        "act": "anticoagulant therapy",
        "agg": "agglutination",
        "ahf": "anti-hemophilic factor",
        "aiha": "autoimmune hemolytic anemia",
        "all": "acute lymphocytic leukemia",
        "aml": "acute myelogenous leukemia",
        "apa": "anti-pernicious anemia",
        "aul": "acute undifferentiated leukemia",
        "b": "blood",
        "baso": "basophil",
        "bl": "bleeding",
        "bmb": "bone marrow biopsy",
        "bmt": "bone marrow transplant",
        "cbc": "complete blood count",
        "cll": "chronic lymphocytic leukemia",
        "cml": "chronic myelogenous leukemia",
        "coag": "coagulation",
        "dic": "disseminated intravascular coagulation",
        "eos": "eosinophil",
        "epo": "erythropoietin",
        "if": "intrinsic factor",
        "itp": "idiopathic thrombocytopenia purpura",
        "lif": "leukemia-inhibitory factor",
        "lymphs": "lymphocytes",
        "mono": "monocyte",
        "paf": "platelet activating factor",
        "plt": "platelet",
        "pmn": "polymorphonuclear neutrophils",
        "pnh": "paroxysmal nocturnal hemoglobinuria",
        "pv": "polycythemia vera",
        "rbc": "red blood cell, red blood cell count",
        "retic": "reticulocyte",
        "rh": "rhesus blood factor",
        "sct": "sickle cell trait",
        "t&c": "type and crossmatch",
        "ttp": "thrombotic thrombocytopenia purpura",
        "wbc": "white blood cell, white blood cell count"
    },
    {
        "_________ is a nerve cell that acts as a messenger.": "neuron",
        "examples of the parasympathetic response": "pupil dilation, increased digestive function, decreased heart rate, bronchiole constriction",
        "_______ connects the left and right hemispheres of the brain.": "commissural fibers",
        "on which receptors does albuterol work?": "beta 2; inhibit (relax) the smooth muscle organs and glands of the sympathetic nervous system.",
        "location and function of baroreceptors": "the carotid sinus and aortic arch; help regulate arterial pressure",
        "_________ is the neurotransmitter for all parasympathetic innervated organs.": "acetylcholine",
        "from where are epinephrine and norepinephrine secreted?": "the adrenal medulla",
        "two types of muscle controlled by the autonomic nervous system?": "cardiac and smooth",
        "enteric nervous system": "branch of the ans that is specifically designated to promote digestive function",
        "dysautonomia is another term for _________. describe this condition.": "autonomic dysfunction; damage to the nerves that results in malfunction of the autonomic nervous system.",
        "alpha-1 receptor activation results in ________ of the blood vessels.": "constriction (primarily arteries)",
        "alpha-2 receptor activation results in ________ of the vessels.": "dilation (primarily arteries); (also inhibits signal transmission at the pre-synaptic terminals)",
        "beta-1 receptor activation results in a(n) ___________ in hr and strength of ____________ in the heart": "increase; contraction",
        "beta-2 receptor activation results in ________ of the bronchioles": "dilation",
        "sympathetic stimulation commonly results in these effects:": "dilation of the pupils and an increase in heart and respiratory rates",
        "parasympathetic stimulation commonly results in these effects:": "constriction of the pupils and a decrease in heart and respiratory rate, as well as improved digestion",
        "what are the two sites for arterial baroreceptors?": "carotid sinus and aortic arch",
        "inotropic effect": "has to do with the strength of cardiac contraction",
        "dromotropic effect": "has to do with the speed of electrical conduction in the heart",
        "chronotropic effect": "has to do with the rate at which the heart contracts (heart rate)",
        "contraction of the lining of the bladder and relaxation of sphincters is a  ______________ response.": "parasympathetic",
        "relaxation of the lining of the bladder and contraction of sphincters is a  ______________ response.": "sympathetic",
        "describe the parasympathetic effect on the reproductive system.": "increased blood flow to the vagina or penis and contraction of smooth muscle to assist orgasm and ejaculation.",
        "describe the sympathetic effect on the reproductive system": "decrease in vaginal secretions and relaxation of the pelvic floor muscles, which makes orgasm and ejaculation more challenging.",
        "the \"fight-or-flight\" response is related to which division of the autonomic nervous system?": "sympathetic",
        "the \"rest and digest\" response is related to which division of the autonomic nervous system?": "parasympathetic",
        "_______ is a hormone and the primary neurotransmitter of the sympathetic nervous system.": "norepinephrine",
        "_______ is the primary neurotransmitter of parasympathetic innervated tissues.": "acetylcholine",
        "autonomic dysfunction": "also known as dysautonomia; refers to damage to nerves within the ans and malfunction of normal processes within this system.",
        "primary dysautonomia": "occurs when autonomic dysfunction is the main disease process.",
        "secondary dysautonomia": "occurs when autonomic dysfunction is a consequence of another disease process.",
        "idiopathic dysautonomia": "occurs when there is no known disease process.",
        "nerve cells that act as \u201cmessengers\u201d by sending and receiving information throughout the body.": "neurons",
        "axon": "this is a long fiber that extends from the cell body of a neuron. it is responsible for electrical impulses that leave the neuron.",
        "dendrites": "branch-like structures that extend from the cell body of the neuron. they receive information from other neurons.",
        "a protective covering around the axon of each neuron.": "myelin sheath",
        "also understood as the outermost layer of schwann cells. these cells are responsible for the production of the myelin sheath.": "neurilemma",
        "immune cells for the cns. they assist in the destruction and removal of harmful microorganisms.": "microglia",
        "astrocytes": "specialized cells in the nervous system; the most abundant glial cells in the cns",
        "primary glial cells in the pns": "schwann cells",
        "provide support for neurons and can be found in the cns and pns": "neuroglia",
        "sensory neurons": "found in the pns, also known as afferent neurons, they respond to sensory information inside and outside of the body, then relay that information to the cns.",
        "motor neurons": "found in the cns, also known as efferent neurons, they send information from the brain and spinal cord to skeletal and smooth muscle cells.",
        "these are found in the cns, and act as the \u201cgo-between\u201d for information that is relayed to and from sensory and motor neurons; also play a role in coordination.": "interneurons",
        "commissural fibers": "connect the right and left hemispheres of the brain.",
        "association fibers": "connect brain regions that are within the same hemisphere.",
        "projection fibers": "connect the brainstem and spine to the cerebral cortex. these fibers are responsible for \u201cprojecting\u201d motor and sensory signals between the cns and pns."
    },
    {
        "what is the name, responsibility, and function of cranial nerve 1 (i)?": "olfactory; sensory; responsible for smell",
        "what is the name, responsibility, and function of cranial nerve 2 (ii)?": "optic; sensory; responsible for vision",
        "what is the name and number of the cranial nerves that aid in eye movement?": "cranial nerve 3 (iii)- oculomotor\ncranial nerve 4 (iv)- trochlear\ncranial nerve 6 (vi)- abducens",
        "which of the cranial nerves have both sensory and motor function?": "cranial nerve 5 (v)- trigeminal\ncranial nerve 7 (vii)- facial \ncranial nerve 9 (ix)- glossopharyngeal\ncranial nerve 10 (x)- vagus",
        "what is the name, responsibility, and function of cranial nerve 12 (xii)?": "hypoglossal; motor; responsible for tongue movement",
        "what is the name, responsibility, and function of cranial nerve 8 (viii)?": "vestibulocochlear; sensory; responsible for hearing and balance",
        "what is the name, responsibility, and function of cranial nerve 11 (xi)?": "accessory; motor; responsible for head movement and shoulder shrugging",
        "afferent neurons are ______  neurons that carry information _______ the brain.": "sensory, towards",
        "efferent neurons are _______  neurons that carry information ______ the brain.": "motor, away",
        "which two of the cranial nerves originate from the cerebrum?": "cranial nerves 1 (i) and 2 (ii)"
    },
    {
        "abp": "arterial blood pressure",
        "acls": "advanced cardiac life support",
        "aed": "automated external defibrillator",
        "afib": "atrial fibrillation",
        "aivr": "accelerated idioventricular rhythm",
        "ami": "acute myocardial infarction",
        "ang": "angiogram",
        "ao": "aorta",
        "ar": "aortic regurgitation",
        "as": "aortic stenosis",
        "ascvd": "anterio-sclerotic heart disease",
        "av": "antrio-ventricular",
        "avb": "antrio-ventricular block",
        "avd": "aortic valve disease",
        "avr": "aortic valve replacement",
        "avs": "arteriovenous shunt",
        "bbb": "bundle branch block",
        "bls": "basic life support",
        "bp": "blood pressure",
        "bpd": "blood pressure diastolic",
        "bpm": "beats per minute",
        "bps": "blood pressure systolic",
        "ca": "cardiac arrest",
        "cabg": "coronary artery bypass graft",
        "cabs": "coronary artery bypass surgery",
        "cad": "coronary artery disease",
        "cea": "carotid endarterectomy",
        "chb": "complete heart block",
        "chd": "congenital heart disease, coronary heart disease",
        "chf": "congestive heart failure",
        "co": "cardiac output",
        "coa": "coarctation of the aorta",
        "cp": "chest pain",
        "cpa": "cardiopulmonary arrest",
        "cpr": "cardiopulmonary resuscitation",
        "cv": "cardiovascular",
        "cvp": "central venous pressure",
        "cvs": "cardiovascular system",
        "dnr": "do not resuscitate",
        "dvt": "deep vein thrombosis",
        "ecc": "emergency cardiac care",
        "ekg": "electrocardiogram",
        "echo": "echocardiography",
        "ef": "ejection fraction",
        "eps": "electrophysiologic study",
        "ett": "exercise tolerance test",
        "hbp": "high blood pressure",
        "hcm": "hypertrophic cardiomyopathy",
        "hcvd": "hypertensive cardiovascular disease",
        "hf": "heart failure",
        "hr": "heart rate",
        "htn": "hypertension",
        "iabp": "intra-aortic balloon pump",
        "icd": "implantable cardiac defibrillator",
        "ish": "isolated systolic hypertension",
        "iv": "intravenous",
        "ivf": "intravenous fluid",
        "jvp": "jugular venous pulse",
        "lbbb": "left bundle branch block",
        "lbp": "low blood pressure",
        "lqts": "long qt syndrome",
        "lvad": "left ventricular assist device",
        "lvet": "left ventricular ejection time",
        "lvh": "left ventricular hypertrophy",
        "mi": "myocardial infarction",
        "mr": "mitral regurgitation",
        "ms": "mitral stenosis",
        "mvp": "mitral valve prolapse",
        "nsr": "normal sinus rhythm",
        "p": "pulse",
        "pac": "premature atrial contraction",
        "pad": "peripheral arterial disease",
        "pals": "pediatric advanced life support",
        "pda": "patent ductus arteriosus",
        "pea": "pulseless electrical activity",
        "ppm": "permanent pacemaker",
        "pst": "paroxysmal supra-ventricular tachycardia",
        "ptca": "percutaneous transluminal coronary angioplasty",
        "pvc": "premature ventricular contractions",
        "pvd": "peripheral vascular disease",
        "rbbb": "right bundle branch block",
        "rhd": "rheumatic heart disease",
        "s1, s2": "heart sound (first, second)",
        "sbe": "subacute bacterial endocarditis",
        "sss": "sick sinus syndrome",
        "svt": "supraventricular tachycardia",
        "tet": "treadmill exercise test",
        "tpa": "tissue plasminogen activator",
        "tr": "tricuspid regurgitation",
        "tt": "thrombolytic therapy",
        "vfib": "ventricular fibrillation",
        "vhd": "valvular heart disease, ventricular heart disease",
        "vpc": "ventricular premature contraction",
        "vsp": "ventricular septal defect",
        "vt, vtach": "ventricular tachycardia",
        "wpw": "wolff-parkinson-white (syndrome)"
    },
    {
        "four quadrants of abdomen": "ruq - right upper quadrant \nluq - left upper quadrant \nrlq - right lower quadrant \nllq - left lower quadrant",
        "scaphoid abdomen": "when the abdomen is viewed laterally with the patient lying supine, having a concave appearance. indicates decreased abd volume.",
        "distended abdomen": "when the abdomen has a rounded or enlarged appearance. indicates increased abd volume.",
        "normal bowel sounds": "gurgles and clicks, every few seconds",
        "abdominal rigidity": "indicates hemorrhage or infection",
        "normal abdomen": "soft, non-tender",
        "these increase the release of gastric acid in the stomach": "drinking alcohol, and smoking tobacco",
        "stretch marks found in abdominal region": "striae, indicate relatively quick change in size of abd",
        "hollow organ pain": "visceral pain - diffuse, aching, cramping",
        "common cause of visceral abd pain": "hollow organ contracting forcefully, or is distended",
        "borborygmi": "\"stomach growling\" - common abd sound",
        "hyperperistalsis": "increased activity in the bowel",
        "pain felt in the peritoneum": "parietal/rebound pain",
        "cause of parietal/rebound pain": "inflammation of the peritoneum, caused by infection or injury",
        "peritoneum defined": "tissue that lines the abd wall and encompasses most organs in the abd region",
        "sign of retroperitoneal hemorrhage": "grey turner sign, flank ecchymosis",
        "sign of intraperitoneal hemorrhage": "cullen sign - bruising around umbilicus",
        "type of diet that increases risk of gi disease": "low-fiber diet",
        "chyme": "mixture of stomach acid and broken down food in the gi tract",
        "clostridium difficile": "aka c-diff. a bacteria that cause infection of the large intestine. severe diarrhea is a common symptom."
    },
    {
        "renal cortex": "kidneys most outer layer",
        "renal medulla": "sits within the renal cortex of the kidney",
        "functional unit of the kidney": "the nephron",
        "nephrons primary function": "filtration",
        "two main goals of the kidney": "keep what the body needs, and pass the rest\nconserve water by concentrating urine",
        "three main kidney processes": "filtration, secretion, reabsorption",
        "secretion defined": "a substance being discharged for a particular function",
        "excretion defined": "expelling waste matter",
        "pathway for urine to travel from the kidney to the bladder": "ureter",
        "nephrons secrete...": "salts, acids, bases, and urea",
        "detrusor muscle": "muscular lining of the bladder",
        "where in the body is ammonia converted to urea?": "the liver",
        "substances commonly reabsorbed by the renal system": "glucose, amino acids, and vitamins",
        "aldosterone": "hormone secreted by the adrenal gland when blood pressure drops too low",
        "renin": "released by the kidney to facilitate production of angiotensin 1",
        "angiotensin converting enzyme": "\"ace\" - convertes angiotensin 1 to angiotensin 2",
        "angiotensin 2": "promotes release of aldosterone, in order to raise blood pressure",
        "bicarbonate buffer system": "major component ph regulation in the blood\nfound in the kidneys",
        "distal convoluted tubule": "\"dct\" - responds to the hormone aldosterone, promoting sodium reabsorption",
        "adh": "\"anti-diuretic hormone\" - promotes reabsorption of water, aka vasopressin"
    },
    {
        "aal": "anterior axillary line",
        "a&d": "ascending and descending",
        "ae": "above the elbow",
        "ak": "above the knee",
        "ant.": "anterior",
        "ap": "anteroposterior",
        "a&p": "anterior and posterior",
        "be": "below the elbow",
        "bilat": "bilateral",
        "bk": "below the knee",
        "ext": "exterior, external",
        "ics": "intercostal space",
        "inf": "inferior",
        "int": "interior, internal",
        "l": "left",
        "lad": "left anterior descending",
        "lao": "left anterior oblique",
        "lat": "lateral",
        "le": "lower extremity",
        "lle": "left lower extremity",
        "lll": "left lower lobe (lung)",
        "llq": "left lower quadrant",
        "lpo": "left posterior oblique",
        "l&r": "left and right",
        "l-r": "left to right",
        "lrt": "lower respiratory tract",
        "l&u": "lower and upper",
        "lue": "left upper extremity",
        "lul": "left upper lobe (lung)",
        "luq": "left upper quadrant",
        "mcl": "mid-clavicular line",
        "ml": "midline",
        "msl": "mid-sternal line",
        "pa": "posteroanterior",
        "post.": "posterior",
        "prox": "proximal",
        "r": "right",
        "rad": "right anterior descending",
        "rao": "right anterior oblique",
        "r-l": "right to left",
        "rle": "right lower extremity",
        "rll": "right lower lobe (lung)",
        "rlq": "right lower quadrant",
        "rml": "right middle lobe (lung)",
        "rpo": "right posterior oblique",
        "rue": "right upper extremity",
        "rul": "right upper lobe (lung)",
        "ruq": "right upper quadrant",
        "sup": "superior",
        "u/l": "upper and lower",
        "ue": "upper extremity",
        "urt": "upper respiratory tract"
    },
    {
        "hematology": "study of blood, and it's interactions with other systems in the body",
        "hemolytic disorders": "diseases that break down red blood cells (rbcs)",
        "hemostatic disorders": "clotting and bleeding abnormalities",
        "blood is what type of tissue?": "connective tissue",
        "plasma": "liquid portion of blood",
        "blood volume in average adult body": "5-6 liters",
        "responsible for carrying oxygen to tissues": "hemoglobin",
        "fibrin": "bodily material that clots are made out of",
        "white blood cell (wbc) function": "maintenance and strengthening of the immune system",
        "hemoglobin is found within what type of blood cell?": "rbc - red blood cell",
        "hematopoietic system": "the organs and tissues involved in the production of blood",
        "tissue portion of blood": "formed elements",
        "formed elements in blood": "99% rbcs - erythrocytes \n1% wbcs - leukocytes, and platelets - thrombocytes",
        "hemostasis": "facilitates the body to control bleeding through coagulation, platelet plugging, and vascular spasm.",
        "clotting cascade": "process in body where clotting factors work together to form fibrin",
        "organ that produces clotting factors": "the liver",
        "stem cells": "cells that develop into other kinds of cells within the body",
        "this portion of blood is 90% water": "plasma, so stay hydrated!",
        "hematocrit": "measures the proportion of rbcs in blood",
        "location of blood platelet storage": "spleen"
    },
    {
        "immune system function": "protects the human body from invading organisms or substances that are foreign, or considered foreign",
        "allergen": "substance that triggers allergic symptoms in an individual",
        "antibody": "aka immunoglobulin, a protein that recognizes an antigen and counteracts its effects",
        "antigen": "foreign substance or organism that triggers an immune response, will trigger antibody response",
        "systemic reaction": "reaction that effects the entire body, usually involving multiple body systems",
        "allergic reaction": "abnormal immune response that occurs after the body has been exposed to an allergen",
        "anaphylaxis": "a severe, potentially life threatening allergic reaction that occurs after the body has been exposed to an allergen that it has a hypersensitivity to",
        "innate immunity": "immunity the body is naturally born with",
        "adaptive immunity": "immunity that is specific to a pathogen, allowing for the immune system to form memory around the invader and the response",
        "integument": "the skin - the body's first line of defense against a threat to health",
        "hypersensitivity": "immune system overreaction to something that is perceived as harmful",
        "biphasic reaction": "an allergic reaction that happens in two phases, once directly after exposure to an allergen, and then later after the initial symptoms have subsided",
        "prolonged reaction": "symptoms of anaphylaxis that can last hours, up to days, at a time",
        "anaphylactoid reaction": "allergic reaction that is clinically similar to anaphylaxis, but is caused by a non-immune mediated response",
        "macrophage cell": "cells that specialize in the identification and destruction of harmful bacteria in the body",
        "natural killer cell": "cells that are the defense against both cancerous and vitally infected cells",
        "chemical mediators": "function to reduce inflammation and promote healing",
        "hematopoiesis": "blood cell production, specifically wbcs, that occurs in the bone marrow",
        "leukocytes": "white blood cells (wbcs) - responsible for counteracting disease and foreign substances",
        "interferon cell": "protein that prevents viral replication, released by virally infected cells"
    },
    {
        "what happens to bladder capacity with aging?": "bladder capacity decreases",
        "what function does a ureter serve?": "ureters drain urine from the kidneys to the urinary bladder",
        "where are the kidney's located?": "left kidney: behind the spleen, just inferior to the rib cage\nright kidney: behind the liver, just inferior to the rib cage",
        "what structures are shared between the urinary and reproductive systems in men?": "the testes, epididymis and vas deferens, prostate gland, and penis",
        "what is the functional unit of the kidney called?": "what is the functional unit of the kidney called?",
        "what is the common name for a renal calculi?": "kidney stone",
        "define: nocturia": "night time urination",
        "define: hematuria": "blood in urine",
        "define: polyuria": "excessive urination",
        "define: dysuria": "discomfort or burning with urination",
        "s/s of kidney stones": "renal colic (severe flank pain) and back pain\nabdominal pain\nmay start as vague visceral pain, progressing to extremely sharp, radiating to pelvis, groin, or genitals\nincreased pain, urgency, and frequency of urination\nhematuria \nfever\npale, cool, clammy skin",
        "what is benign prostate hypertrophy?": "noncancerous enlargement of the prostate",
        "what structures do the female reproductive system share with the urinary system?": "none",
        "what are the main functions of the urinary system?": "regulation of blood volume\nregulation of ph (acid/base) \nregulation of water/electrolyte balance\nblood filtration\nremoving waste and toxins\nregulating arterial blood pressure\nproduction of red blood cells\nregulation of glucose",
        "is the urinary bladder classified as a solid or hollow organ?": "",
        "define: renal colic": "a severe form of sudden onset flank pain",
        "s/s: epididymitis": "1. swelling and pain in the scrotum \n2. enlarged testes\n3. swollen groin on affected side\n4. testicular pain that worsens with bowel movement\n5. fever\nf. urethral discharge",
        "s/s: fourmier\u2019s gangrene": "1. crepitus of skin\n2. grey/black color of tissues with significant drainage \n3. fever\n4. pain",
        "define: phimosis": "condition where the foreskin is too tight to be pulled around the head of the penis",
        "define: priapism": "painful and prolonged erection",
        "four categories of uti (based on location)": "urethritis: in the urethra\ncystitis: in the urinary bladder\nprostatitis: prostate gland (men)\npyelonephritis: kidney",
        "define: pyelonephritis": "a type of uti, specifically an infection in the kidney",
        "define: nephron": "the functional unit of the kidney",
        "define: ureter": "structure that drains urine from the kidney to the bladder",
        "preferred analgesic for flank pain": "tordol (ketorolac) has been shown to be most effective for renal colic (flank pain)\nnarcotics are the second choice, if tordol isn't available",
        "most common ph issue that arises from a gu disorder": "metabolic acidosis",
        "at what age is testicular torsion most likely to occur?": "can occur at any age, however more common in early adolescence and infancy",
        "changes to gu system in elderly (8)": "1. reduction in renal function\n2. reduction in renal blood flow\n3. tubule degeneration\n4. decreased bladder capacity \n5. decline in sphincter muscle control\n6. decline in voiding senses\n7. increase nocturia\n8. benign prostatic hypertrophy (males)",
        "define: benign prostatic hypertrophy (bph)": "noncancerous enlargement of the prostate",
        "s/s: testicular torsion": "1. sudden onset of severe pain in one testis\n2. swelling on one side of scrotum\n3. testicular lump\n4. blood in semen",
        "how does the urinary system regulate arterial blood pressure?": "urine formation\nrenin-angiotensin system"
    },
    {
        "cns": "central nervous system - responsible for thought, feeling, perception, and autonomic body functions",
        "pns": "peripheral nervous system - responsible for transmitting information from brain to body and from body to brain",
        "occipital lobe of brain function": "vision, and visual memory storage",
        "parietal lobe of brain function": "storage of tactile memories, sense of touch and texture",
        "temporal lobe of brain function": "hearing and smell\nlanguage center\nstorage of sound and odor memories",
        "frontal lobe - motor cortex function": "voluntary muscle control\nstorage of spatial memories",
        "frontal lobe - prefrontal cortex function": "site of abstract intellectual functions \njudgement and prediction of consequences",
        "limbic system function": "basic emotions\nbasic reflexes",
        "thalamus (within the diencephalon) function": "relay center for sensory and motor signals, allowing prioritization of important messages",
        "hypothalamus (within the diencephalon) function": ""
    },
    {
        "introduction": "the human nervous system is broken up into the peripheral nervous system and the central nervous system. the brain, along with the spinal cord, is part of the central nervous system. there are two types of cells in the brain, nerve cells, and glial cells. nerve cells send and receive messages via nerve pathways and glial cells help provide the brain with nutrition and support.",
        "anatomy and physiology review": "the skull protects the brain matter. the skull is made up of the cranium and the bones of the face. between the skull and the brain there are three layers of tissue. starting with the layer furthest from the brain they are the dura mater, the arachnoid mater, and the pia mater. the space between the dura mater and the arachnoid mater is called the subdural space and the space between the arachnoid mater and the pia mater is called the subarachnoid space. starting from the bottom of the brain, the spinal cord leads to the brainstem. the brainstem is made of the midbrain, pons, and medulla oblongata. the brainstem relays messages from the body to the brain and has an influence on breathing, blood pressure, and alertness. towards the back of the head is the cerebellum, a region controlling fine motor skills. above the cerebellum is the occipital lobe, which helps process visual information. the parietal lobes help receive information from all other regions of the brain, order it, and also develop memory. bordering the parietal lobes are the temporal lobes, which help recognize objects, faces, and language.",
        "recognition": "though there are entire courses on the brain and brain anatomy, not all of that information is needed for ems professionals. when there is an issue with the brain, it generally presents as altered mental status (ams). sometimes the reason for the ams is obvious such as the patient was hit in the head with a baseball bat. sometimes it is more of a mystery to solve and working through a process can help identify the root cause of the altered mentation. frequently, the pneumonic aeiou-tips is used in the prehospital setting. a: alcoholism or acidosis e: environmental exposure, epilepsy, electrolytes, encephalopathy, endocrine disease i: infection o: oxygen deficiency, overdose u: underdose, uremia t: trauma i: insulin, intestinal p: psychogenic, poisons s: stroke, shock",
        "aeiou-tips pneumonic": "a: alcoholism or acidosis e: environmental exposure, epilepsy, electrolytes, encephalopathy, endocrine disease i: infection o: oxygen deficiency, overdose u: underdose, uremia t: trauma i: insulin, intestinal p: psychogenic, poisons s: stroke, shock",
        "another pneumonic": "oxygen: check oxygen saturation glucose: check blood sugar pump: check heart rhythm, rate, and 12 lead ecg s: structural such as stroke or trauma i: infection such as sepsis t: toxin such as drug overdose s: social or psych after all other causes have been thoroughly vetted",
        "treatment": "treatment for ams starts with identifying the cause of the altered state of the patient. from that point on treatment can go from oxygen therapy to iv dextrose to rapid sequence intubation.",
        "scenario": "you are called to a public park where there is a young man unconscious on the ground. he appears to be in his mid-twenties and there are two empty beer cans lying next to him. the scene is safe and controlled. what do you do first? after bsi and scene safety, a primary survey should be conducted. the patient is found to have a patent airway, be taking irregular breaths, and a slow, bounding radial pulse. the patient is responsive to pain. a: alcoholism or acidosis? there is some obvious alcohol use but two cans should not put a patient in this state. no obvious signs of acidosis e: environmental exposure, epilepsy, electrolytes, encephalopathy, endocrine disease? the patient is warm to the touch with no signs of hypo or hyperthermia. the patient has no bit tongue, no fistula, and no signs of hyperkalemia on the cardiac monitor as well. no obvious signs of encephalopathy or endocrine disease. i: infection? no infection site seen. o: oxygen deficiency, overdose? no track marks or drug paraphernalia found, oxygen saturation reads 99% room air. u: underdose, uremia? no pill bottles or prescriptions with patient, no signs of chf or other cause of uremia t: trauma? a full physical assessment reveals a closed skull fracture with indentation at the rear of the skull. this patient now has a suspected cause of the altered mentation. i: insulin, intestinal? capillary blood glucose is normal p: psychogenic, poisons? no sign of any toxin or foul play s: stroke, shock? the patient is inconclusive on the stroke scale but now has injury and mentation indication brain injury. due to the closed skull fracture, the patient should be transported to the largest trauma center available to transport to. obtain iv access. aggressive airway management should occur as the patient does not have the ability to protect their airway. once the patient is intubated, mild hyperventilation should take place to lower the etco2 to help lower icp and secondary brain injury from the pressure of an inflamed brain. focus on having a short scene time and rapid transport code 3 as definitive care for this patient is surgery or specialized care at a trauma center.",
        "final thoughts": "use family and friends as a resource for patients who are exhibiting ams. they can be a wealth of knowledge for when the change in a patient occurred and/or the events going on when the patient's mentation changed. they can also answer questions like has this ever happened before? using these resources are key because once the patient is in the ambulance and you drive away you have no accurate reporter to provide additional information on the patient."
    },
    {
        "introduction": "the nervous system is one of the most complex systems in the body. it is responsible for our ability to interpret both internal needs and environmental stimuli. due to the complexity of the nervous system, it is subdivided to understand its various responsibilities better. the first two divisions are the central and peripheral nervous systems (commonly referred to as the cns and pns, respectively). the cns consists of the brain and spinal cord. the pns encompasses all nerves that branch from the cns to organs and muscles throughout the body. to better understand the pns, we further divide it into the autonomic and somatic nervous systems (ans and sns, respectively). some of our organs are \"involuntary\" or out of our conscious control. examples include our heart, kidneys, and digestive tract. these involuntary muscles and organs make up the ans. an easy way to remember this is that they are \"automatic.\" other organs and muscles, however, are \"voluntary\" or largely within our control. these include the muscles in our legs or arms and make up the sns.",
        "ans overview": "so\u2026what is the ans? ans stands for the autonomic nervous system. the ans comprises the organs and muscles that are \"automatic\" or involuntarily controlled by our pns. what does the ans encompass? ans is responsible for involuntary functions like heart, digestive, and respiratory rates. it is broken down into two categories: the parasympathetic and sympathetic nervous systems. the parasympathetic nervous system is responsible for the relaxation or slowing of involuntary processes, such as slowing the heart rate when you sleep. the sympathetic nervous system is often called the \"fight-or-flight\" response and speeds up processes such as increasing the heart rate when you exercise or feel threatened.",
        "key terms": "neuron - nerve cells that act as \"messengers\" by sending and receiving information throughout the body. axon - a long fiber that is an extension of the neuron. it is responsible for electrical impulses that leave the neuron. dendrites - branch-like structures that are part of the neuron. they receive information from other neurons. myelin sheath - a protective covering around the axon of each neuron. neurilemma - also known as schwann cells. these cells are responsible for the production of the myelin sheath. microglia - immune cells for the cns. they also help regulate inflammation. astrocytes - specialized glial cells that are the most abundant in the cns. schwann cells - main glial cells in the pns. neuroglia - provide support for neurons and can be found in the cns and pns.",
        "lessons and concepts": "neurons are the foundational cells of the nervous system and are broken down based on their role and how they transmit information, i.e.: sensory or afferent neurons are found in the pns. they detect and relay information from both inside and outside the body to the cns. motor or efferent neurons are found in the cns. they send information from the cns to skeletal and smooth muscle cells. interneurons are found in the cns. they are the \"go-between\" for information relayed to and from sensory and motor neurons. they also play a role in coordination. nerves are found in the pns, and nerve tracts are found in the cns. sensory nerves enable us to sense the world through sight, taste, sound, touch, and smell. motor nerves relay signals from the cns to the muscles in the body to prompt movement. mixed nerves or interneurons send both sensory and motor signals.",
        "sympathetic and sympathetic divisions of the ans": "the sympathetic division is responsible for the \"fight-or-flight\" response. increases heart and respiratory rate and prepares muscles for activation. decreases digestion. norepinephrine is the primary neurotransmitter of the sympathetic nervous system. it is both a hormone and a neurotransmitter and helps to elevate both blood pressure and heart rate. the parasympathetic division is responsible for the \"rest & digest\" response. promotes digestion. decreases heart rate and allows for a restful state. acetylcholine (ach) is the neurotransmitter found at all parasympathetic innervated organs.",
        "effects of the ans on organs/organ systems": "eyes: sympathetic response causes dilation of pupils to help with vision. parasympathetic response cause tear production, improves close vision, and constricts pupils. skin: sympathetic response causes an increase in sweating and vasoconstriction of the blood vessels. cardiovascular system: medulla helps regulate arterial pressure through sympathetic and parasympathetic nerves. baroreceptors are part of a negative feedback system that helps regulate arterial pressure.",
        "autonomic dysfunction or dysautonomia": "dysautonomia or autonomic neuropathy is common though the severity and onset can vary from person to person. men and women are equally affected, and symptoms may be present at birth or develop later in life. primary dysautonomia occurs when autonomic dysfunction is the main disease process. secondary dysautonomia occurs when autonomic dysfunction results from another disease process, such as diabetes. idiopathic dysautonomia occurs when there is no known disease process.",
        "treatment and management of dysautonomia": "prioritize needs. patients experiencing dizziness or hypotension may be at greater risk for falling when standing and, therefore, may require additional resources to move/transport. initial actions: assess and manage airway, breathing, and circulation as needed. based on patient presentation, als may be necessary, so calling early is a high priority if als is not already available.",
        "the peripheral nervous system": "to have an even better understanding of the pns, we can break it down even further. we know that some of our organs are \"involuntary\" or out of our conscious control. examples include our heart, kidneys, and digestive tract. these involuntary muscles and organs are innervated by the autonomic nervous system or ans. an easy way to remember this is that they are \"automatic\". other organs and muscles, however, are \"voluntary\" or within our control. these include the muscles in our legs and arms and make up the somatic nervous system or sns.",
        "the autonomic nervous system": "the ans can again be divided into two more categories: the parasympathetic (pans) and sympathetic (sans) nervous systems.",
        "what is the ans?": "ans stands for the autonomic nervous system. the ans makes up the organs and muscles that are \"automatic\" or involuntarily controlled by our pns",
        "what does the ans encompass?": "the ans is responsible for involuntary functions, including heart rate, digestive function, and respiratory rate. it is broken down into two categories: the parasympathetic and sympathetic nervous systems",
        "the parasympathetic nervous system": "the parasympathetic nervous system is responsible for the relaxation - or slowing - of these involuntary processes",
        "the sympathetic nervous system": "the sympathetic nervous system is responsible for the \"fight-or-flight\" response, meaning it \"speeds up\" many involuntary processes",
        "neuroglial cells": "there are four types of neuroglial cells: astrocytes, ependymal cells, microglial cells, and oligodendrocytes",
        "nerve impulses": "nerve impulses are electrical signals that tell neurons to react to a stimulus. for example, you naturally withdraw from painful stimuli",
        "membrane potential": "membrane potential is the difference between the electrical charge on the inside versus the outside of the cell",
        "depolarization": "depolarization (first half of action potential) occurs when potassium leaves the cell, and sodium and calcium enter the cell.",
        "repolarization": "repolarization (second half of action potential) occurs when sodium and calcium leave the cell and potassium enters the cell.",
        "impulse transmission": "impulse transmission occurs in two different ways depending on how fast or slow the messages need to be sent and received",
        "distribution pattern of spinal nerves": "sensory pathways. the posterior column pathway - also called the dorsal columns medial lemniscus pathway, is responsible for touch and pain sensations; it also allows for the conscious sensation of where the body is in space",
        "motor pathways": "pyramidal system - travel through pyramids of the medulla, responsible for the voluntary control of muscles",
        "sympathetic division of the autonomic nervous system": "\"fight-or-flight\" increases heart rate and respiratory rate and prepares muscles for activation",
        "parasympathetic division of the autonomic nervous system": "\"rest & digest\" promotes digestion. decreases heart rate and allows for a restful state",
        "effects of the sympathetic and parasympathetic divisions of the ans": "eyes. the sympathetic response causes dilation of pupils to help with vision. the parasympathetic response cause tear production, improves close vision, and constrict pupils",
        "autonomic dysfunction aka dysautonomia": "damage to nerves of the ans may result in malfunction in the pans, sans, or both",
        "symptoms": "bladder control and sensation issues. frequent urination or incontinence. difficulty regulating temperature, heart rate, and blood pressure",
        "treatment and management": "prioritized needs: patients who are experiencing dizziness or hypotension may be at greater risk of falling when standing; therefore, you may need additional resources to help when moving the patient",
        "scenario": "dispatch info: you are dispatched to the local high school for a 16-year-old female who had a syncopal episode.",
        "key takeaways": "the initial presentation of the patient was stable, with no indications of acute distress. the patient's recent history during volleyball practice and the events surrounding her syncopal episode prompted ems involvement.",
        "tips and tricks": "body functions that take place without any thought are \"automatic\" and therefore controlled by your autonomic nervous system",
        "the autonomic nervous system (ans)": "to have an even better understanding of the pns, we can break it down even further. we know that some of our organs are \"involuntary\" or out of our conscious control. examples include our heart, kidneys, and digestive tract. these involuntary muscles and organs are innervated by the autonomic nervous system or ans. an easy way to remember this is that they are \"automatic.\" other organs and muscles, however, are \"voluntary\" or within our control. these include the muscles in our legs and arms and make up the somatic nervous system or sns.",
        "the ans and its categories": "the ans can again be divided into two more categories: the parasympathetic (pans) and sympathetic (sans) nervous systems.",
        "types of neuroglial cells": "there are four types of neuroglial cells: astrocytes, ependymal cells, microglial cells, and oligodendrocytes microglia - immune cells for the cns. they target invaders and remove debris within the cns astrocytes - specialized glial cells that are the most abundant in the cns ependymal cells - secrete cerebrospinal fluid (csf) and encapsulate critical neural tissue oligodendrocytes - insulation of axons within cns",
        "neurons": "neurons, the foundational cells of the nervous system, are broken down based on their role within the nervous system and how they transmit information. for example: sensory neurons, also known as afferent neurons, are found in the pns and respond to sensory information inside and outside the body. they are responsible for relaying that information to the cns think \"arrive\" at the cns motor neurons, also known as efferent neurons, are found in the cns and send information from the brain and spinal cord to skeletal and smooth muscle cells think \"exit\" from the cns interneurons are found in the cns, the \"go-between\" for information that is relayed to and from sensory and motor neurons, and play a role in coordination",
        "nerves": "nerves are groupings of neurons that direct a signal to a target location sensory nerves are responsible for your ability to sense the world around you through sight, taste, sound, touch, and smell motor nerves send signals from the cns to the muscles in the body to prompt movement mixed nerves can send both sensory and motor signals. an example is the facial nerve. the facial nerve controls facial movement (motor) and taste (sensory)",
        "nerve tracts": "nerve tracts are found in the cns, more specifically in the white matter of the brain, which is located deep to the grey matter and also makes up most of the brain tissue nerve tracts are classified into three categories based on what they connect commissural fibers connect the right and left hemispheres of the brain association fibers connect brain regions that are within the same hemisphere projection fibers connect the brain stem and spine to the cerebral cortex. these fibers are responsible for \"projecting\" motor and sensory signals between the cns and pns",
        "action potential": "depolarization (first half of action potential) occurs when potassium leaves the cell, and sodium and calcium enter the cell. this action potential causes normal body functions to occur, such as a heartbeat repolarization (second half of action potential) occurs when sodium and calcium leave the cell and potassium enters the cell. this is also known as resting potential. this explains the pause between heartbeats",
        "effects of the sympathetic and parasympathetic divisions of the ans on various organs and systems of the body": "eyes the sympathetic response causes dilation of pupils to help with vision the parasympathetic response cause tear production, improves close vision, and constrict pupils skin the sympathetic response causes an increase in sweating and vasoconstriction of the blood vessels",
        "cardiovascular system": "the medulla helps regulate arterial pressure through sympathetic and parasympathetic nerves baroreceptors are part of a negative feedback system that helps regulate arterial pressure. there are two sites for arterial baroreceptors carotid sinus is located at the bifurcation of the external and internal carotids. small changes in mean arterial pressure (map) will activate these receptors to adjust back to normal by either increasing or decreasing map",
        "symptoms of dysautonomia": "bladder control and sensation issues frequent urination or incontinence difficulty regulating temperature, heart rate, and blood pressure orthostatic hypotension syncope fatigue vertigo forgetfulness increase or lack of sweating chest pain shortness of breath migraines with possible noise and light sensitivity cardiac rhythm disturbances digestion issues nausea/vomiting hypoglycemia constipation sexual dysfunction erectile dysfunction increased vaginal dryness or pain during intercourse decrease in, or loss of, libido changes in vision blurriness",
        "ongoing treatment/treatment goals": "iv/io access may be necessary for administering medications to help with blood pressure or heart rate continual cardiac monitoring (4 or 12-lead) etco2 and/or spo2 monitoring maintain/improve vital signs to within normal limits",
        "transport considerations": "consider facilities with cardiac and stroke capabilities when patients present with acute cardiac disturbances or neurological deficits patients with difficult airways may require transport to the closest facility"
    },
    {
        "introduction": "a&p of the upper and lower airway",
        "anatomy of the upper airway": "the upper airway serves as a passageway for food, liquids, and air. it also heats, humidifies, and filters the air. the upper airway provides a path for coughing, swallowing, and speech.",
        "structures of the upper airway": "pharynx: refers to the mouth, nasal cavity, and portion of the upper airway which all connect and lead to the esophagus and trachea. oropharynx: mouth and throat. nasopharynx: nasal cavity leading to throat. laryngopharynx: found beneath the hyoid bone, branching area where food and air pass to either the esophagus or the trachea. larynx: vocal cords or the structure marking the split between the upper and lower airway. allows for the passage of air into and out of the lungs. protects the lungs from aspiration and is involved in the production of speech. esophagus: muscular tube connecting the mouth and throat to the stomach allowing for passage of food and liquids.",
        "common airway terms": "epiglottic vallecula: depression at the root of the tongue between tongue and epiglottis. traps food, liquids, and saliva to prevent the swallowing reflex. epiglottis: flap of elastic cartilage connected at the root of the tongue. responsible for opening and closing the entrance to the windpipe as a means to prevent aspiration. vocal cords (also known as larynx): the vocal cords are a key component in one's ability to speak, however, they are also crucial in protecting the lower airway from aspiration.",
        "movement of air": "air passes from the upper airway and into the lower airway. it is then directed into one of two main airways, the right and left main bronchi. next, it will move into smaller passages called bronchioles, and finally into the terminal ends of the airway. the lower airway terminates in extremely small sacks where gas exchange occurs, called alveoli.",
        "gas exchange": "gas exchange occurs by diffusion, which is molecules moving from high concentrations to low concentrations. for example, when blood reaches the pulmonary capillaries, it contains minimal amounts of oxygen and high amounts of carbon dioxide. the alveoli contain high amounts of oxygen and minimal amounts of carbon dioxide.",
        "lower airway structures": "trachea: wind-pipe or a cartilaginous structure leading from the larynx down to the carina where it further splits into the lungs. carina: cartilaginous structure between the trachea and primary bronchi, produces a branching area separating the left and right lung. bronchus: larger airways composed primarily of cartilage leading from the trachea. these structures continue deeper into the lungs and branch into different pathways including the primary, secondary and tertiary bronchi. bronchioles: smaller, muscular structures found deep in the lungs between the bronchi and alveoli. alveoli: tiny air-sacs composed of single-layered tissue where gas exchange occurs between the lungs and the pulmonary capillaries.",
        "physiology": "remember that the main goal of the respiratory system is gas exchange. a disruption in either the movement of air (ventilation) or gas exchange (respiration) will result in poor or inadequate perfusion. perfusion refers to an adequate volume of oxygen in the bloodstream and the ability of that oxygen to reach vital tissues.",
        "common physiology terms": "ventilation: process of moving air in and out of the lungs. respiration: process of gas exchange across the alveoli. tidal volume: amount of airway moved in or out of the lungs in one breath, or with each respiratory cycle (inhalation or exhalation). respiratory rate: count of breaths taken per minute. perfusion: passage of blood and all of its contents through organs, tissues, and the vascular system. hypoxia: inadequate amounts of oxygen reaching tissues. hypoxemia: inadequate amounts of oxygen within the bloodstream, primarily referring to amounts within the arteries."
    },
    {
        "introduction": "anatomy and physiology overview of the cranial nerves. the human brain has 12 cranial nerves. there are three general types of cranial nerves, afferent nerves, efferent nerves, and mixed nerves. afferent nerves receive sensory input from the body and move it to the central nervous system (cns) and brain. efferent nerves pass impulses from the brain and cns to the motor system and control movement, specifically of the face.",
        "cranial nerves": "i: olfactory nerve. (sensory) receives sensory input from the molecules in the nose and sends neural messaging back to the olfactory bulb. ii: optic nerve. (sensory) receives sensory input from eyes via nerves that meet at the optic chasm. input is sent back to the opposite side of the brain from the eye the sensory input comes from. iii: oculomotor nerve. (motor) controls motor function of eyes. also controls pupillary response as they respond to light. iv: trochlear nerve (motor) controls the oblique muscles. these muscles control outward, inward, and downward eye movements. v: trigeminal nerve (both) the largest cranial nerve. the trigeminal nerve is divided into 3 separate divisions, the maxillary (which sends sensory information from the middle of the head), the ophthalmic division (which sends sensory information from the scalp, forehead, and upper eyelids), and the mandibular division (which sends both sensory and motor information from the jaw, chin, lower lip, and tongue). vi: abducens nerve (motor) controls outwards eye motor movements. vii: facial nerve (both) transmits sensory input from the taste buds as well as controlling muscle function for tear production and saliva production. viii: vestibulocochlear nerve (sensory) consists of two divisions, the vestibular division, and the cochlear division. the vestibular division collects sensory input on balance and orientation. the cochlear branch receives sensory input from the inner ear regarding sound and pitch. ix: glossopharyngeal nerve (both) a sensory and motor nerve that carries nerve impulses for swallowing and the gag reflex. x: vagus nerve (both) the longest cranial nerve, divided into the left and right vagus nerves. a large focus of the parasympathetic response within the body involving the heart, lungs, and digestive system. xi: spinal accessory nerve (motor) a motor nerve that is associated with movement of the head, neck, and shoulders. xii: hypoglossal nerve (motor) a motor nerve that controls the movement of the tongue.",
        "prehospital assessment and treatment": "in patients with suspected cranial nerve damage or head injury, a prehospital crania nerve assessment can be very useful for helping make a clinical impression of the injury and track changes in the patient's neurologic deficits. the cranial nerve assessment is less useful for massive head trauma or an obvious stroke with a large vessel occlusion. in those patients, it is not a hard assessment to determine that there is an injury to the brain. the cranial nerve assessment is really useful for in-between situations. a minor fall, a roll-out of bed, a patient that seems ok but just a little off. the cranial nerve assessment allows you to gather more information to help have a better guess at the severity of the injury to the patient. the pneumonic peee ffutss can be used for a complete cranial nerve assessment.",
        "cranial nerve assessment": "pupils: use penlight to confirm pupillary response. eyes: test eye motion to all fields of direction. eyelids: have the patient close their eyes and try to keep them closed. using your fingers lightly, try to push the eyelids up so the eyes are open. they should not be able to open their eyes. ears: compare hearing in each ear and ask about ringing or other noises. facial sensation and mastication: hold the sides of the patient's mandibles and ask them to pretend like they are chewing. observe for equal strength. have the patient close their eyes and touch different parts of the face to test sensation. facial movement: have the patient smile and observe for symmetry. uvula: ask the patient to open their mouth and say 'ahhhhhh.' observe uvula to not have any traumatic damage and to be midline. tongue: ask the patient to stick out their tongue. the tongue should stick out normal. swallow: ask the patient to swallow and observe for any abnormalities. shrug: resting your hands on the patient's shoulders, have them shrug. their strength should be equal.",
        "scenario": "you are dispatched to some sort of accident on the road. when you arrive, it looks like an electric scooter had hit a pothole at around 20 mph and the rider is sitting on the curb. there is a helmet sitting next to the rider with a solid dent in it. when making patient contact, the patient is a/o x4, gcs 15, but very slow to answer questions. the patient states they don't need to go to the hospital. you are not comfortable letting the patent sign a refusal also you ask if they will let you conduct a cranial nerve exam. the cranial exam conducted shows deficits within their shrug, eye movement, and eyelid strength. you decide to call online medical control to convince the patient to go to the hospital and they are successful. you conduct serial cranial nerve assessments throughout the transport and pick up on progressing neurological symptoms. this allows you to anticipate the need for advanced airway interventions before the patient crashes, even though the patient still has the same gcs score.",
        "final thoughts": "the brain is the most important part of the body and also one that is so protected it can be hard to assess. due to this, conducting cranial nerve assessments can be an extremely valuable resource to assess brain injury, but also track changes in condition of patients with a brain injury. consistent assessments of the cranial nerves throughout time of patient care can help paramedics and emts anticipate changes in the patient condition before they occur."
    },
    {
        "introduction": "the nervous system is one of the most complex systems in the body. it is responsible for our ability to interpret both internal needs and environmental stimuli. due to the complexity of the nervous system, it is subdivided to understand its various responsibilities better. the first two divisions are the central and peripheral nervous systems (commonly referred to as the cns and pns, respectively). the cns consists of the brain and spinal cord. the pns encompasses all nerves that branch from the cns to organs and muscles throughout the body. to better understand the pns, we further divide it into the autonomic and somatic nervous systems (ans and sns, respectively). some of our organs are \"involuntary\" or out of our conscious control. examples include our heart, kidneys, and digestive tract. these involuntary muscles and organs make up the ans. an easy way to remember this is that they are \"automatic.\" other organs and muscles, however, are \"voluntary\" or largely within our control. these include the muscles in our legs or arms and make up the sns.",
        "ans overview": "so\u2026what is the ans? ans stands for the autonomic nervous system. the ans comprises the organs and muscles that are \"automatic\" or involuntarily controlled by our pns. what does the ans encompass? ans is responsible for involuntary functions like heart, digestive, and respiratory rates. it is broken down into two categories: the parasympathetic and sympathetic nervous systems. the parasympathetic nervous system is responsible for the relaxation or slowing of involuntary processes, such as slowing the heart rate when you sleep. the sympathetic nervous system is often called the \"fight-or-flight\" response and speeds up processes such as increasing the heart rate when you exercise or feel threatened.",
        "key terms": "neuron - nerve cells that act as \"messengers\" by sending and receiving information throughout the body. axon - a long fiber that is an extension of the neuron. it is responsible for electrical impulses that leave the neuron. dendrites - branch-like structures that are part of the neuron. they receive information from other neurons. myelin sheath - a protective covering around the axon of each neuron. neurilemma - also known as schwann cells. these cells are responsible for the production of the myelin sheath. microglia - immune cells for the cns. they also help regulate inflammation. astrocytes - specialized glial cells that are the most abundant in the cns. schwann cells - main glial cells in the pns. neuroglia - provide support for neurons and can be found in the cns and pns.",
        "lessons and concepts": "neurons are the foundational cells of the nervous system and are broken down based on their role and how they transmit information, i.e.: sensory or afferent neurons are found in the pns. they detect and relay information from both inside and outside the body to the cns. motor or efferent neurons are found in the cns. they send information from the cns to skeletal and smooth muscle cells. interneurons are found in the cns. they are the \"go-between\" for information relayed to and from sensory and motor neurons. they also play a role in coordination.",
        "sympathetic and sympathetic divisions of the ans": "the sympathetic division is responsible for the \"fight-or-flight\" response. increases heart and respiratory rate and prepares muscles for activation. decreases digestion. norepinephrine is the primary neurotransmitter of the sympathetic nervous system. it is both a hormone and a neurotransmitter and helps to elevate both blood pressure and heart rate. the parasympathetic division is responsible for the \"rest & digest\" response. promotes digestion. decreases heart rate and allows for a restful state. acetylcholine (ach) is the neurotransmitter found at all parasympathetic innervated organs.",
        "effects of the ans on organs/organ systems": "eyes: sympathetic response causes dilation of pupils to help with vision. parasympathetic response cause tear production, improves close vision, and constricts pupils. skin: sympathetic response causes an increase in sweating and vasoconstriction of the blood vessels.",
        "autonomic dysfunction or dysautonomia": "dysautonomia or autonomic neuropathy is common though the severity and onset can vary from person to person. men and women are equally affected, and symptoms may be present at birth or develop later in life. primary dysautonomia occurs when autonomic dysfunction is the main disease process. secondary dysautonomia occurs when autonomic dysfunction results from another disease process, such as diabetes.",
        "treatment and management of dysautonomia": "prioritize needs. patients experiencing dizziness or hypotension may be at greater risk for falling when standing and, therefore, may require additional resources to move/transport. initial actions: assess and manage airway, breathing, and circulation as needed.",
        "scenario": "dispatch info - you are dispatched to the local movie theater for a 28-year-old pregnant female who had a syncopal episode. scene info - when you arrive, her friends wave you into a theatre and tell you that after the movie, your patient passed out almost immediately upon standing up to exit.",
        "key takeaways": "the initial presentation of the patient was that she was stable and in no acute distress. event and patient history, specifically her pregnancy are vital to painting the complete picture of what is possibly going on with this patient."
    }
]